A study on the relationship between the prognosis of chronic active hepatitis and the HBV associated antigen/antibody systems.

The relationship between the prognosis of the disease based on liver histology and HB virus (HBV) associated antigen/antibody systems was investigated in twenty seven patients with chronic active hepatitis (CAH). These patients were followed up over extended periods with mean duration of 44.3 months. On initial liver biopsy five of twelve patients with CAH with spotty or focal necrosis were HBs antigen (HBsAg) positive, as were also five of six patients with sublobular necrosis and six of nine patients with lobular disorganization. Most of the HBsAg negative patients were anti-HBs or anti-HBc positive: HBV associated antigen or antibody was completely undetectable in only three of the twenty seven patients. There was no difference in the frequency of progression to liver cirrhosis (LC) between the sixteen HBsAg positive and the eleven HBsAg negative patients with CAH. On the other hand, progression to LC occurred in only one of seven HBe antigen (HBeAg) negative patients, compared to four of nine HBeAg positive patients, who were HbsAg positive. There were four patients who were HBeAg positive initially but then became HBeAg negative in the course of observation. LC developed in two of these four patients. These results suggest that in HBsAg positive patients with CAH the presence or absence of HBeAg and the variation in its level can provide useful indicators of the prognosis of the disease.