מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Most patients chronically infected with hepatitis B virus become negative for hepatitis B e antigen (HBeAg) within 10 years, according to the results of a population-based study among Alaskan Natives. The findings are reported in the November 6th issue of the Annals of Internal Medicine,
Dr. Brian J. McMahon from the Alaska Native Medical Center, Anchorage, and colleagues collected data on 1536 Alaska Natives with chronic hepatitis B, who were part of a surveillance program to detect carriers with hepatocellular carcinoma. The researchers followed these subjects from the first positive HBsAg test for 19,430 person-years.
Among these subjects, 641 were hepatitis B e antigen (HBeAg) positive and 893 were anti-HBe positive. Over 10 years there was a 72.5% probability of clearing HBeAg, with older carriers significantly more likely than younger carriers to do so (p < 0.001), the investigators found. Clearance of HBsAg was associated with being older and having a positive anti-HBe on initial testing.
The incidence of hepatocellular carcinoma was 1.9 per 1000 carrier-years. The risk increased with age, and with reversion from anti-HBe to HBeAg-positive status, Dr. McMahon's team reports. The risk was also increased among those of Yupik Eskimo ethnicity compared with other Eskimo groups.
Although treatment of HBeAg-positive carriers with interferon-alpha or lamivudine results in significantly higher clearance in the short-term, it is not clear that the benefit is maintained over the long term, Dr. McMahon and colleagues note. Further studies are needed to provide an answer to that question, they say.
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