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Abstract
A 60-mo longitudinal study has been undertaken in 99 HBeAg-positive patients with
clinicopathologically verified chronic hepatitis. Hepatitis B e antigen clearance
occurred in 30 patients at a rate of approximately 17% per year. A phenomenon of abrupt
elevation of serum glutamic pyruvic transaminase (greater than 300 IU/L) with histological
changes compatible with chronic lobular hepatitis was observed in 13 of 20 patients
(65%) preceding spontaneous HBeAg clearance. In contrast, 8 of 10 patients on immunosuppressive
or antiviral therapy, or both, had uneventful HBeAg clearance. It was concluded that
HBeAg clearance can occur in patients with varying immunologic status. The mechanism
responsible for HBeAg clearance awaits further study.