Long-term follow-up of HBeAg-positive young adult Japanese patients treated with corticosteroid withdrawal therapy for chronic hepatitis B.

OBJECTIVES

To evaluate the long-term effects of corticosteroid withdrawal therapy (CSWT) in young adult Japanese patients with chronic hepatitis B (CH-B) virus infection.

METHODS

The subjects were 106 patients with CH-B who received CSWT, were less than 35 years of age and had been followed for more 10 years after CSWT.

RESULTS

Retreatment was not required in 41 patients (38.7%; retreatment(-) group) while 65 (61.3%) received treatment after the initial CSWT (retreatment(+) group). Larger proportions of patients of the retreatment(-) group were females, had liver histology stage F2/F3, high ICG R15, and genotypes A/B/D/E, compared with the retreatment(+) group. At the last follow-up examination, the HBeAg seronegative rate was 90.2% in the retreatment(-) group and 98.5% in retreatment(+) group. In the retreatment(-) group, the rate of liver cirrhosis (LC; 7.3%, 3 patients) was lower, but the rate of hepatocellular carcinoma (HCC; 12.2%, 5 patients) was higher than in the retreatment(+) group (20%, 13 patients, and 4.6%, 3 patients, respectively). At the 10-year period, the overall HBsAg loss, LC and HCC rates were 2.8, 13.2 and 1.9%, respectively.

CONCLUSIONS

Our results suggest that CSWT is good short-term therapy and has possible long-term effects in young adult Japanese patients with CH-B.