Division of Liver Diseases, Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY 10001, USA.
Semin Liver Dis. 2010 Aug;30(3):296-301. doi: 10.1055/s-0030-1262515. Epub 2010 Jul 21.
We present a patient with HBeAg-negative chronic hepatitis B, in whom significant regression of hepatic fibrosis was achieved after a lengthy antiviral treatment. A liver biopsy specimen obtained at initiation of treatment showed chronic hepatitis B with mild activity (histologic activity index: 7) and marked fibrosis (stage 4, in a scale of 0 to 6). A second biopsy specimen, obtained 10 years later, demonstrated almost complete resolution of necroinflammatory activity and fibrosis. One year after the second biopsy, seroconversion from HBsAg positive to anti-HBs positive status was achieved, and antiviral treatment was discontinued. This case is illustrative of the significant histologic improvement that can be accomplished in chronic hepatitis B when viral activity is suppressed long term. Lengthy antiviral treatment can achieve resorption of excess fibrous tissue, even in patients with marked fibrosis.
我们报告了一位 HBeAg 阴性慢性乙型肝炎患者，经过长期抗病毒治疗后，肝纤维化显著消退。治疗开始时获得的肝活检标本显示慢性乙型肝炎伴轻度活动（组织学活动指数：7）和明显纤维化（4 期，0 至 6 级）。10 年后获得的第二次肝活检标本显示几乎完全缓解了坏死性炎症和纤维化。第二次肝活检后 1 年，HBsAg 从阳性转为抗-HBs 阳性，抗病毒治疗停止。该病例说明，当病毒活性长期受到抑制时，慢性乙型肝炎可以获得显著的组织学改善。长期抗病毒治疗可以吸收多余的纤维组织，即使在有明显纤维化的患者中也是如此。
