A patient with chronic hepatitis B and regression of fibrosis during treatment

• Published in: Seminars in liver disease Vol. 30; no. 3; p. 296
• Main Authors: Chang, Charissa Y, Martin, Paul, Fotiadu, Anastasia, Hytiroglou, Prodromos
• Format: Journal Article
• Language: English
• Published: United States 01-08-2010
• Subjects: Antiviral Agents - administration & dosage; Biopsy; DNA, Viral - blood; Drug Administration Schedule; Hepatitis B Antibodies - blood; Hepatitis B Surface Antigens - blood; Hepatitis B virus - genetics; Hepatitis B virus - immunology; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - diagnosis; Hepatitis B, Chronic - drug therapy; Humans; Liver Cirrhosis - drug therapy; Liver Cirrhosis - pathology; Liver Cirrhosis - virology; Male; Middle Aged; Time Factors; Treatment Outcome; Viral Load
• ISSN: 1098-8971
• DOI: 10.1055/s-0030-1262515

We present a patient with HBeAg-negative chronic hepatitis B, in whom significant regression of hepatic fibrosis was achieved after a lengthy antiviral treatment. A liver biopsy specimen obtained at initiation of treatment showed chronic hepatitis B with mild activity (histologic activity index: 7) and marked fibrosis (stage 4, in a scale of 0 to 6). A second biopsy specimen, obtained 10 years later, demonstrated almost complete resolution of necroinflammatory activity and fibrosis. One year after the second biopsy, seroconversion from HBsAg positive to anti-HBs positive status was achieved, and antiviral treatment was discontinued. This case is illustrative of the significant histologic improvement that can be accomplished in chronic hepatitis B when viral activity is suppressed long term. Lengthy antiviral treatment can achieve resorption of excess fibrous tissue, even in patients with marked fibrosis.