Effects of prednisolone/azathioprine in chronic hepatitis B viral infection.

Open Access
Publisher Website
Google Scholar
Abstract
Changes in markers of hepatitis B viral (HBV) replication and standard liver function tests were studied in 30 patients with [hepatitis B surface antigen] HBsAg positive chronic liver disease starting or stopping prednisolone/azathioprine therapy, and compared with those occurring in 15 patients who did not receive therapy. On stopping prednisolone/azathioprine, 10 of 11 hepatitis Be antigen [HBeAg] positive patients and 1 of 3 patients negative for HBeAg and anti-hepatitis Be antigen antibody [anti-HBe] lost HBV-DNA polymerase activity (P < 0.01), 5 lost HBeAg, 3 developed anti-HBe and HBsAg concentration decreased (P < 0.01). Only 1 of 7 untreated HBeAg positive patients lost HBeAg and there were no significant changes in DNA polymerase activity. In the anti-HBe positive patients, 14 starting therapy and 8 untreated, there were no significant changes in the markers of viral replication, although 2 patients developed DNA polymerase activity on high maintenance doses of prednisolone, but a significant decrease (P < 0.05) in aspartate transaminase in the treated group. Thus, the cessation of prednisolone/azathioprine therapy in HBeAg positive patients apparently will result in a reduction in viral replication. In anti-HBe positive patients such therapy may be beneficial.