Infection
Persists After Clinical Recovery in Acute, Self-Limited Hepatitis B
Occult
hepatitis B virus (HBV) often persists in the liver long after recovery becomes
apparent in patients with acute, self-limited infections, researchers report.
A medical
team at Osaka National Hospital in Japan has explored long-term histologic and
virologic outcomes in patients with acute, self-limited HBV infections.
According to the team's findings, many patients' livers still exhibit
abnormalities and harbor viral infections ten years after clinical recovery.
The
long-term investigation, headed by Nobukazu Yuki, included 14 patients with
previous diagnoses of acute hepatitis B. The study, initiated a median of 4.2
years after the patients' disease was confirmed (range=1.8-9.5), continued for
several more years, with at least nine of the 14 patients undergoing liver
biopsies at a median of 7.2 years.
When the
study began, none of the patients had circulating HBV surface antigen (HBsAg),
and all but two had formed antibodies to HBsAg. "Three patients had low levels
of HBV DNA up to 8.9 years after the onset, whereas HBV DNA surface and X
regions were found in the liver of all nine patients examined, including seven
negative for serum HBV DNA," Yuki and colleagues reported.
The liver
biopsies demonstrated a significant relationship between HBV DNA surface and X
regions, the authors said. In addition, all patient's samples contained
covalently closed circular HBV DNA.
Liver
fibroids and mild inflammation were detected by researchers in eight of
the biopsied patients. "The fibrosis stage had relation to peak serum HBV DNA in
the acute phase (p=0.046), but not to liver viral loads in the convalescent
phase," said investigators.
Yuki and colleagues
conclude that occult HBV infection may persist in the liver longer than
suspected in patients who recover from acute, self-limited hepatitis B.
05/19/03
Sources S Nichols. Infection Persists After Clinical Recovery in Acute
Self-Limited Hepatitis B. Hepatitis Weekly. May 12, 2003
Long-Term
Histologic and Virologic Outcomes of Acute Self-Limited Hepatitis B.
Hepatology 37(5):1172-1179. May 2003.
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