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Long-term clinical and histological outcomes in patients with spontaneous hepatitis B surface antigen seroclearance

 Sang Hoon Ahn  ;  Young Nyun Park  ;  Jun Yong Park  ;  Hye-Young Chang  ;  Jung Min Lee  ;  Ji Eun Shin  ;  Kwang-Hyub Han  ;  Chanil Park  ;  Young Myoung Moon  ;  Chae Yoon Chon 
 JOURNAL OF HEPATOLOGY, Vol.42(2) : 188-194, 2005 
Journal Title
Issue Date
Adult ; Base Sequence ; Carrier State/blood ; DNA Primers ; DNA, Viral/blood ; DNA, Viral/genetics* ; DNA, Viral/isolation & purification ; Hepatitis B/blood ; Hepatitis B/pathology ; Hepatitis B Surface Antigens/blood* ; Hepatitis B e Antigens/blood ; Humans ; Liver/pathology ; Liver/virology ; Metabolic Clearance Rate ; Middle Aged ; Necrosis ; Viral Load
Hepatitis B virus ; Hepatitis B Surface Antigen ; Histology ; Fibrosis ; Outcomes
BACKGROUND/AIMS: During the natural course of hepatitis B virus (HBV) infection, the long-term clinical and histological outcomes following spontaneous hepatitis B surface antigen (HBsAg) seroclearance remain unclear.
METHODS: Between 1984 and 2003, 49 (9.5%) out of 432 inactive HBsAg carriers had no detectable level of circulating HBsAg. Fifteen of 49 patients had undergone paired peritoneoscopic liver biopsies.
RESULTS: During a mean follow-up period of 19.6 months after HBsAg seroclearance, 5 of 49 (10.2%) patients were noted to have HCC. Liver cirrhosis (P=0.040), a history of perinatal infection (P=0.005) and long-standing duration (at least 30 years) of HBsAg positivity (P=0.002) were associated with a significantly higher risk of developing HCC. Despite HBsAg seroclearance, HBV DNA was detected in the liver tissues from all 15 patients who underwent paired liver biopsies. Necroinflammation was significantly ameliorated (P<0.0001). On the other hand, amelioration of the fibrosis score did not reach a statistically significant level (P=0.072). Interestingly, aggravation of liver fibrosis was evident in 2 patients (13.3%) including one who had rapidly progressed to overt cirrhosis.
CONCLUSIONS: In patients with spontaneous HBsAg seroclearance, necroinflammation was markedly improved and liver fibrosis was unchanged or regressed despite occult HBV infection. However, HCC developed in a minority of cases.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Park, Chan Il(박찬일)
Shin, Ji Eun(신지은)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Chang, Hye Young(장혜영)
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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