这是一份44个乙肝住院病人的5年追踪报告，41个病人清除了表面抗原 ，3/44(6.8%)转为慢性感染

Genes (Basel). 2018 Jun; 9(6): 293.

Published online 2018 Jun 12. doi: 10.3390/genes9060293

PMCID: PMC6027296

PMID: 29895748

Long-Term Follow-Up of Acute Hepatitis B: New Insights in Its Natural History and Implications for

Antiviral Treatment

Stefano Menzo,1,* Claudia Minosse,2 Donatella Vincenti,2 Laura Vincenzi,3 Fabio Iacomi,3 Paola Zaccaro,2 Gianpiero D’Offizi,3 and Maria R. Capobianchi2

 

3.2. Clinical Outcome, Natural History and HBsAg Clearance

All 75 patients were cared for as inpatients for a few days on supportive treatment: Hydration, glucose, and electrolytic balance. Three patients with particularly high levels of liver damage were treated with entecavir until anti-HBsAg seroconversion. After clinical improvement, all patients were discharged, and most were further followed at the same center as outpatients. Clinical data recorded during the hospital stay or collected during follow-up visits were analyzed for the study. None of the patients reported or were documented as having been vaccinated. Twenty-six patients were lost during follow-up after a short hospital stay, 49 were followed as outpatients for a variable amount of time. Of these, 44 were followed to HBsAg clearance or for longer than five years. For the purposes of this study, HBsAg clearance was defined as the intermediate time between the last positive and the first negative result. By this definition, 36/44 patients cleared HBsAg within six months (Rapid Resolvers, RR), as shown in Figure 2A. Of the other eight (Slow Resolvers, SR), three (3/44, 6.8%) developed a true chronic HBeAg+ infection (>4 years now, two of them requiring chronic antiviral treatment). SR were infected with: Four genotype A, two genotype F, and one of genotype D and B respectively. Of these, two genotype A and one genotype B infections became chronic. Genotype D infection in adults showed the lowest probability of lasting longer than six months (6.7% vs. 22% non–D genotypes, not significant).