HBeAg/anti-HBe system in the acute phase of HBsAg-positive hepatitis as a predictive test of developing chronic hepatitis

HBsAg-positive acute hepatitis cases were tested for HBe system in the acute phase of the disease and in the follow-up period. 70% of patients studied within the first week after onset of symptoms were found to be HBeAg-positive. 75% of patients became HBeAg-negative within 2 weeks of hospitalization. Only 5 patients (2.5%) had still detectable HBeAg during the follow-up period (6 months-1 year). No statistically significant differences were noted in HBeAg clearance and seroconversion to anti-HBe in the different epidemiological groups or in the different age groups. Clinical and biochemical data of the acute phase of the disease were not related to the positivity of HBe system or to HBeAg clearance. 104 of the 136 patients (76.5%) were considered recovered after 6-12 months of follow-up. All the HBeAg-positive patients (5 cases) developed a chronic hepatitis. 5 of the 9 (55.5%) HBsAg and anti-HBe positive patients also developed a chronic hepatitis. Drug addicts seem to develop chronic hepatitis more frequently even if it is not in relation to the persistence of HBsAg and/or HBeAg. In conclusion, these data support the hypothesis that persistence of HBeAg for more than 2 months is a prognostic marker for the development of chronic hepatitis. Seroconversion to anti-HBe, even if it occurs early in the symptomatic phase of the disease, is not always related to the recovery from HBsAg-positive acute hapatitis.