Hepatitis B virus DNA prediction rules for hepatitis B e antigen-negative chronic hepatitis B.

Hepatitis B virus DNA prediction rules for hepatitis B e antigen-negative chronic hepatitis B. Research Abstract Details 

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Hepatitis B virus DNA prediction rules for hepatitis B e antigen-negative chronic hepatitis B. Abstract Text:

Jordan J Feld,Melissa Ayers,Dahlia El-Ashry,Tony Mazzulli,Raymond Tellier,E Jenny Heathcote,

After hepatitis B e antigen (HBeAg) seroconversion, hepatitis B may become inactive or progress to HBeAg-negative hepatitis with persistent or intermittent alanine aminotransferase (ALT) elevation. The aim of this study was to prospectively identify factors predictive of the clinical course in HBeAg-negative chronic hepatitis B (CHB). Patients were stratified by ALT and HBeAg status and followed every 3 months for up to 5 years. Kaplan-Meier and Cox regression analysis using the change from normal ALT to elevated ALT as endpoints were performed to determine factors associated with ALT elevation/normalization. Seventy-four HBeAg-negative and 32 HBeAg-positive patients were prospectively evaluated. For HBeAg-negative patients, hepatitis B virus (HBV) DNA was predictive of future ALT. Only 1 patient with normal ALT and an HBV DNA value lower than 10,000 copies/mL developed an elevated ALT within the subsequent year, whereas 67% with an HBV DNA value greater than 100,000 copies/mL had a rise in ALT above normal within 1 year. Patients with a previous history of ALT elevation and longer follow-up at all levels of HBV DNA were more likely to experience ALT elevations. For HBeAg-negative patients with elevated ALT and all HBeAg-positive patients, HBV DNA did not predict future ALT. Other viral and host factors were not predictive of future ALT. CONCLUSION: HBeAg-negative CHB has a fluctuating course. HBV DNA values lower than 10,000 copies/mL predict persistently normal ALT for at least 1 year. Patients with HBV DNA values between 10,000 and 100,000 copies/mL can safely be followed at 6 monthly intervals, whereas HBV DNA values greater than 100,000 copies/mL are highly predictive of future ALT elevation and should prompt regular follow-up.

Hepatitis B virus DNA prediction rules for hepatitis B e antigen-negative chronic hepatitis B. Publishing Authors By Initials

JJ Feld,M Ayers,D El-Ashry,T Mazzulli,R Tellier,EJ Heathcote,

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Hepatitis B virus DNA prediction rules for hepatitis B e antigen-negative chronic hepatitis B. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Hepatology (Baltimore, Md.)

VOLUME: 46

Page Numbers: 1057-70

Journal Abbreviation: Hepatology

ISSN: 0270-9139

DAY: 30

MONTH: Oct

YEAR: 2007

Hepatitis B virus DNA prediction rules for hepatitis B e antigen-negative chronic hepatitis B. Information

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LANGUAGE: eng

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Grant and Affiliation Information for Hepatitis B virus DNA prediction rules for hepatitis B e antigen-negative chronic hepatitis B.

AFFILIATION: Department of Medicine, University of Toronto, Toronto, Canada. feldj@niddk.nih.gov

Country: United States

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MEDLINETA: Hepatology

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