Sustained Remission After Corticosteroid Therapy of Severe Hepatitis B Surface Antigen-Negative Chronic Active Hepatitis

被引:83
作者
Czaja, Albert J. [1 ]
Beaver, Sandy J.
Shiels, Mark T.
机构
[1] Mayo Clin, Div Gastroenterol, Rochester, MN 55902 USA
关键词
D O I
10.1016/0016-5085(87)90862-6
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
To determine the frequency of a sustained remission and to assess the long-term prognosis of relapse and retreatment, 66 patients with severe hepatitis B surface antigen-negative chronic active hepatitis and prolonged follow-up after initial corticosteroid withdrawal (mean, 10 +/- 0.4 yr) were evaluated. Selection of patients was made from among 206 cases of severe disease. Twenty-four patients (36%) sustained remission for at least 5 yr (mean, 11 +/- 0.6 yr) after initial therapy, and 42 (64%) relapsed and were retreated. Patients who sustained remission had shorter durations of illness before therapy (8 +/- 1 vs. 14 +/- 2 mo, p < 0.05) and they had greater laboratory improvements during treatment. The frequencies of cirrhosis and death were not significantly greater in patients who relapsed. Of the 42 patients who relapsed, 9 (21%) ultimately entered a sustained remission after retreatment. Remission for at least 5 yr was possible in 33 of the 66 patients (50%). Major drug complications developed more commonly in those who relapsed and required retreatment (59% vs. 29%, p < 0.05). We conclude that 50% of patients who enter remission during initial therapy may ultimately achieve a sustained remission, especially if their disease is of short duration and adequately suppressed during treatment. Relapse does not affect long-term prognosis, but retreatment is associated with more side effects.
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页码:215 / 219
页数:5
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