[Mid-term natural course in Naples of chronic HBeAg positive infection caused by the HB-virus. Prospective study, preliminary to antiviral treatment]. / L'andamento naturale a medio termine a Napoli della infezione cronica da HB-virus HBeAg positiva. Studio prospettivo, preliminare al trattamento antivirale.

41 consecutively observed patients with chronic HB virus infection in replication phase (HBeAG positive) were followed up for an average period of 60 months with a view to evaluating the frequency of spontaneous HBeAg/anti-HBe seroconversion and the influence of the event on the clinical course of the liver disease. The 41 patients, of mean age 22 years, suffered from: 26 ECP, 7 ECA, 8 CIRR. 18 patients (41%) presented HBeAg/anti-HBe seroconversion with an annual percentage of 12%, all with stable normalisation of hepatic cytolysis tests. Factors related to HBeAg/anti-HBe seroconversion were: female sex, higher mean starting values of transaminase, positive history for EVA, absence of Virus Delta superinfection. The effectiveness of antiviral treatments will only be demonstrated when seroconversion (inhibition of viral replication) is produced much more frequently than that which occurs spontaneously. Candidates for current antiviral treatment are indicated.

Antiviral therapy in HBsAg-positive chronic liver disease (HBsAg+ve CLD): how many patients really need it?

One hundred and seventy-one consecutive patients with HBsAg+ve CLD were investigated in order to assess whether they were actively replicating the hepatitis B virus, and therefore eligible for antiviral therapy. Our results show that only 5.8% of patients were actively replicating B virus and therefore antiviral therapy, when available, could be used only for a small subgroup of patients suffering from CLD due to hepatitis B virus chronic infection.