Ohlen I, Liegl J M, Selmair H
Klinik Wartenberg, Wartenberg/Obb.
Leber Magen Darm. 1995 Dec;25(6):259-62.
146 patients (62 female, 84 male) with chronic hepatitis B were regularly examined in 1 to 2 year intervals with an average follow-up period of 12 years (means). Each time patients were evaluated by physical examination, routine laboratory data, immunological and serological testing, ultrasonography, and laparoscopy and/or percutaneous liver biopsy. No patient of the study underwent immunosuppressive or antiviral treatment at any time. The average time data in years and months are given as the median value (mean). Frequency and date of seroconversion from HBeAg to anti-HBe after the first diagnosis of HBV-infection: in patients with chronic persistent hepatitis (CPH) in 79% of cases after 8 years, in patients with chronic active hepatitis (CAH) in 72% of cases after 7 years, and in patients with liver cirrhosis in 61% of cases after 9 years. The overall seroconversion rate in all patients with chronic hepatitis B amounted to 68% 8.5 years after the first diagnosis of HBV-infection. Clinical and prognostic significance: The seroconversion from HBeAg to anti-HBe mostly led to substantial and sustained biochemical and histologic resolution of liver disease activity. In patients with CPH in 100% of cases after 15 months, in patients with CAH in 87% of cases after 17 months, and in patients with liver cirrhosis in 64% of cases after 2.5 years. 80% of these patients with seroconversion and histologic recovery remained HBV-DNA (PCR)-positive.
146例慢性乙型肝炎患者（62例女性，84例男性），每隔1至2年定期接受检查，平均随访期为12年（均值）。每次对患者进行体格检查、常规实验室数据、免疫和血清学检测、超声检查以及腹腔镜检查和/或经皮肝活检评估。该研究中的患者在任何时候均未接受免疫抑制或抗病毒治疗。以中位数（均值）给出以年和月为单位的平均时间数据。首次诊断为HBV感染后HBeAg血清学转换为抗-HBe的频率和日期：慢性持续性肝炎（CPH）患者中，8年后79%的病例出现血清学转换；慢性活动性肝炎（CAH）患者中，7年后72%的病例出现血清学转换；肝硬化患者中，9年后61%的病例出现血清学转换。所有慢性乙型肝炎患者的总体血清学转换率在首次诊断为HBV感染后8.5年时为68%。临床和预后意义：HBeAg血清学转换为抗-HBe大多导致肝病活动在生化和组织学上显著且持续缓解。CPH患者中，15个月后100%的病例出现缓解；CAH患者中，17个月后87%的病例出现缓解；肝硬化患者中，2.5年后64%的病例出现缓解。这些血清学转换且组织学恢复的患者中，80%的患者HBV-DNA（PCR）仍为阳性。
