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High Levels of HBV after Onset Lead to Chronic in Acute Hepatitis B
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High Levels of HBV after Onset Lead to Chronic in Acute Hepatitis B

High Levels of HBV after the Onset Lead to Chronic Infection in Patients with Acute Hepatitis B

    Hiroshi Yotsuyanagi1,7,
    Kiyoaki Ito2,5,7,
    Norie Yamada1,3,4,
    Hideaki Takahashi3,
    Chiaki Okuse3,
    Kiyomi Yasuda4,
    Michihiro Suzuki3,
    Kyoji Moriya1,
    Masashi Mizokami2,
    Yuzo Miyakawa6, and
    Kazuhiko Koike1

+ Author Affiliations

    1Department of Internal Medicine, Graduate School of Medicine, University of Tokyo, Bunkyo, Tokyo, Japan
    2The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa, Japan
    3Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
    4Department of Internal Medicine, Center for Liver Diseases, Kiyokawa Hospital, Suginami, Tokyo, Japan
    5Department of Microbiology and Immunology, Aichi Medical University School of Medicine and
    6Miyakawa Memorial Research Foundation, Minato, Tokyo, Japan

    Corresponding Address requests for reprints to: Hiroshi Yotsuyanagi, MD, Graduate Institute of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo 113-8655, Japan. e-mail: hyotsu-***@****; phone: 81-3-5800-8801, fax: 81-3-5800-8804.

    ↵7 H.Y. and K.I equally contributed to this work

Abstract

Background. Some patients with acute HBV infection develop chronic infection. However, the method for identifying them has not been established.

Methods. We followed 215 Japanese patients with acute HBV infection until the clearance of HBsAg or the development of chronic infection. Levels of HBsAg and HBV DNA were serially monitored from the onset.

Results. Of the 215 patients, 113 (52.5%) possessed HBV genotype A, 26 (12.0%) genotype B, and 73 (34.0%) genotype C. Twenty-one of the 215 (9.8%) developed chronic infection, with the persistence of HBsAg for>6 months. The rate of chronicity of genotype A, B, and C was 12.4%, 3.8%, and 8.2%. Of the 21 patients, only six (2.8%) patients, including five with genotype A, failed to clear HBsAg within 12 months. Levels of HBsAg at 12 weeks and HBV DNA at 4 weeks were useful for distinguishing the patients who became chronic from those who did not (P <.001 and P<.001, respectively). Likewise, the levels of HBsAg at 12 weeks and HBV DNA at 8 weeks were useful for discriminating between the patients who lost HBsAg within 12 months and those who did not (P<.01 and P<.05, respectively).

Conclusions. In acute HBV infection, clearance of HBV may happen between 6 and 12 months from the onset. Only those who fail to clear HBV within 12 months from the onset may really develop chronic infection.

    Received February 14, 2013.
    Accepted May 9, 2013.

    © The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.***@****.
Tags: HBV acute chronic
7 Comments Post a Comment
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Avatar_m_tn
Interesting post,thanks for sharing what attracted my attention is that some patients cleared by 12 months so i think more important is hbsag deceease than to clear in 6 months which in case of not clearing is not definitive that you become chronic.
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Avatar_m_tn
would be interesting to see how high was hbv dna levels in thouse who did not clear hbs.
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Avatar_m_tn
Yes, it is interesting to note that some may take more than 6 months post infection to clear the virus. But overall, the study confirms that most infected adults do clear the virus on their own.
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Avatar_m_tn
I am sure the numbers are in the full paper.
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Avatar_m_tn
hi stephenCastlecrag i was diagnosed with hepatitis b infection last 2009 of January and last year i undergo HVB DNA and result is 365copies/ml and after 6 months last Sept 2012 i undergo again for HVB DNA and the result is 65.7copie/ml, what does it mean? pls help me thanks
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Avatar_m_tn
little to nothing if you want to know if the infection is clearing.hbvdna is not the test to show clearance of hbv infection you need hbsag quantitative to know if you are clearing
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Avatar_m_tn
If you are under treatment, this means your treatment is working. If you are not under treatment, it means your immune system is keeping the virus under control. If your ALT is also normal, it means your disease is inactive at the moment.
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