[Prognostic value of HBe antigen and anti-HBe antibody in viral hepatitis B (author's transl)]

Abstract

HBe antigen (Ag) and anti-HBe antibody (Ab) were detected in 50 patients with chronic hepatitis due to virus B. In 19 cases of non-specific hepatitis and 15 cases of chronic persistent hepatitis, there was a significant correlation (p less than 0.01) between biochemical disturbances and the presence of HBe Ag. In 13 cases of HBs Ag-positive chronic persistent hepatitis (9 with HBe Ag and 4 with anti-HBe Ab) followed up for a mean period of 15 months, the biochemical disturbances were associated with the presence of HBe Ag and they subsided when the anti-HBe Ab appeared. In 4 cases of persistent chronic hepatitis and 16 cases of chronic active hepatitis followed up biochemically and histologically for a mean period of 22 months, aggravation of hepatic lesions was observed in the 8 cases where HBe Ag persisted. Conversely, histological improvement and return to normal of biochemical values were noted in 8 of the 12 remaining cases (5 seroconversions HBe Ag/Ab, 1 seroconversion HBs Ag/Ab, 3 HBs Ag and HBc Ab, and 3 HBs Ab). The results of treatment with corticosteroids alone or combined with azathioprine appeared to correlate with changes in HBe serology rather than with the pharmacological effects of the drugs. It would therefore seem that the disappearance of HBe Ag is a prerequisite of improvement of hepatitis B and that the HBe Ag/anti-HBe Ab system is an excellent prognostic index, as it closely reflects the evolutive potential of the disease, which in turn governs all therapeutic measures.