711 HEPATITIS B VIRUS (HBV) INFECTION IN BELGIUM: RESULTS OF THE BELGIAN ASSOCIATION FOR THE STUDY OF THE LIVER (BASL) REGISTRY OF 1421 HBSAG CHRONIC CARRIERS

response and improved clinical outcome in HBeAg positive patients. In previous studies, age, gender, ALT, AFP, fibrosis, HBV-DNA, precore/core promoter mutation, HLA, and genotype are considered to be important factors for HBeAgSC. The aim of our study is to identify predicting factors for HBeAgSC within a year. Methods: From 1991 to 2005, liver biopsies were performed on 851 Hepatitis B s antigen positive patients in our hospital. From this group, 234 HBeAg positive patients were chosen to be subjects for this study. In 60 (26%) patients, HBeAgSC was observed within a year after liver biopsy, but in the remaining 174 (74%) patients, HBeAgSC was not observed. We compared the following factors between the two groups; age; gender; ALT; platelets; albumin; AFP; pathological features; HBeAg; HBV DNA; HBcrAg levels; mutations in the precore (G1896A) / core promoter (A1762T / G1764A) domain; and antiviral treatments. Results: Age (37 vs. 37: n.s.); gender (M/F) (43/17 vs. 118/56: n.s.); median ALT level (213 vs.125 IU/L: p = 0.004); median platelets level (171 vs. 186×103/ml: n.s.); median albumin level (4.1 vs. 4.1 g/dl: n.s.); median AFP level (12.0 vs. 6.0: p = 0.048); F0–1/2–4 (13/47 vs. 75/99: 0.043); cell infiltration in portal area 0–1/2–4 (12/48 vs. 59/115: 0.043); piecemeal necrosis 0–1/2–4 (20/40 vs. 91/83: 0.011); lobular inflammation 0–1/2–4 (15/45 vs. 80/94: p = 0.004); median HBeAg level (99 vs. 888 s/co: p< 0.000); median HBV DNA level (7.2 vs.8.0 log copies/ml: p< 0.000); median HBcrAg level (7.2 vs. 8.1 LogU/ml: p < 0.000), antiviral treatment (yes/no) (29/31 vs. 62/112: n.s.). Under multivariate analysis, HBeAg (<500 s/co), lobular inflammation (≥2), precore mutant, core promoter mutant were identified as independent factors for HBeAgSC. Especially, the patients with 2 favorable predictors (HBeAg and lobular inflammation) achieved HBeAgSC in 55% of cases. But, the patients without 2 favorable factors experienced HBeAgSC in only 6 % of cases. Conclusions: Low serum HBeAg level (<500) and severe lobular inflammation (≥2) are independent factors for HBeAgSC within a year. HBeAgSC could be predicted by evaluation for these two factors.