Fujiyama S, Sagara K, Takano J, Iwaoka D, Deguchi T, Mizuno K, Ohtomo N
Gastroenterol Jpn. 1979 Dec;14(6):604-10. doi: 10.1007/BF02773719.
The HBeAg was detected in 5 of 24 patients with acute type B hepatitis (20.8%), 33 of 95 with chronic hepatitis (34.7%), 6 of 33 with liver cirrhosis (18.2%), and 3 of 39 with hepatocellular carcinoma (7.7%). On the other hand, anti-HBe was found in 4.2% of acute hepatitis, 18.9% of chronic hepatitis, 9.1% of liver cirrhosis, and 12.8% of hepatocellular carcinoma. We found that an early detection of HBeAg in patients with acute hepatitis is of no prognostic value, but its persistence may provide the earliest evidence of potential chronicity. In chronic liver diseases, HBeAg-positive cases showed remarkable fluctuations of serum transaminase levels, severe histological changes and poor responses to treatment. Many of the HBeAg-positive patients lost their initial positivity of HBeAg within six months or one year and in some cases serocoverted to anti-HBe after acute exacerbation. Follow-up study more than several years revealed that the presence of anti-HBe reflect an inactive stage and a more favorable outcome, whereas persistence of HBeAg may provide an active and continuing hepatocellular damage. From these results, we believed that serial measurements of HBeAg/anti-HBe system are useful prognostic marker in patients with HBsAg-positive liver disease.
24例急性乙型肝炎患者中有5例（20.8%）检测到HBeAg，95例慢性肝炎患者中有33例（34.7%），33例肝硬化患者中有6例（18.2%），39例肝细胞癌患者中有3例（7.7%）。另一方面，抗-HBe在急性肝炎患者中的检出率为4.2%，慢性肝炎患者中为18.9%，肝硬化患者中为9.1%，肝细胞癌患者中为12.8%。我们发现，急性肝炎患者中HBeAg的早期检测无预后价值，但其持续存在可能是潜在慢性化的最早证据。在慢性肝病中，HBeAg阳性病例血清转氨酶水平波动显著，组织学改变严重，对治疗反应不佳。许多HBeAg阳性患者在6个月或1年内失去了最初的HBeAg阳性，在某些情况下，急性加重后血清转换为抗-HBe。数年以上的随访研究表明，抗-HBe的存在反映了疾病的静止期和较好的预后，而HBeAg的持续存在可能提示肝细胞持续受到活动性损害。根据这些结果，我们认为连续检测HBeAg/抗-HBe系统对HBsAg阳性肝病患者是有用的预后指标。
