Spontaneous reactivation in chronic hepatitis B: Patterns and natural history

Sanjeev Gupta, Sugantha Govindarajan, Tse Ling Fong, Allan G. Redeker

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

We identified spontaneous reactivation of hepatitis B virus (HBV) retrospectively by utilizing serum alanine aminotransferase and HBV DNA in 19 men (79% homosexual), with an estimated annual incidence of 7.3%. In 11 patients, spontaneous reactivation occurred as a single episode and in eight patients, reactivation was recurrent, with two to five episodes each. The mean serum alanine aminotransferase level was elevated over 10-fold at the peak of reactivation. Serum anti-HB<inf>c</inf> IgM was detected during 73% of the reactivation episodes. Actuarial analysis revealed that reactivation was long lasting with 45% and nearly 20% of episodes continued after 6 and 24 months, respectively. The course of 24 chronic HBV carriers with a negative serum HBV DNA test and normal alanine aminotransferase levels at initial appearance was unremarkable. We could not identify clinical features predictive of reactivation or its resolution. Severe reactivation hepatitis occurred in three patients (10%), with two deaths (6%). None of the patients lost HB<inf>s</inf>Ag. Spontaneous reactivation in chronic hepatitis B can appear variably, persist long term, recur, and be fatal. Therefore, accurate classification of chronic HBV infection requires prolonged observation, and spontaneous reactivation should be considered a variable in therapeutic trials for chronic hepatitis B.

Original languageEnglish (US)
Pages (from-to)562-568
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume12
Issue number5
StatePublished - 1990
Externally publishedYes

Fingerprint

Chronic Hepatitis B
Natural History
Hepatitis B virus
Alanine Transaminase
Serum
Actuarial Analysis
DNA
Virus Diseases
Hepatitis B Surface Antigens
Hepatitis
Observation
Incidence

Keywords

  • Hepatitis
  • Hepatitis B virus
  • Liver
  • Reactivation

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Spontaneous reactivation in chronic hepatitis B : Patterns and natural history. / Gupta, Sanjeev; Govindarajan, Sugantha; Fong, Tse Ling; Redeker, Allan G.

In: Journal of Clinical Gastroenterology, Vol. 12, No. 5, 1990, p. 562-568.

Research output: Contribution to journalArticle

Gupta, S, Govindarajan, S, Fong, TL & Redeker, AG 1990, 'Spontaneous reactivation in chronic hepatitis B: Patterns and natural history', Journal of Clinical Gastroenterology, vol. 12, no. 5, pp. 562-568.
Gupta, Sanjeev ; Govindarajan, Sugantha ; Fong, Tse Ling ; Redeker, Allan G. / Spontaneous reactivation in chronic hepatitis B : Patterns and natural history. In: Journal of Clinical Gastroenterology. 1990 ; Vol. 12, No. 5. pp. 562-568.
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