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Spontaneous Clearance and Reactivation of Hepatitis B Virus Infection Among Male Homosexuals with Chronic Type B Hepatitis

ROBERT P. PERRILLO, M.D.; CAROLYN R. CAMPBELL, B.S.; GARY E. SANDERS, Ph.D.; FREDRIC G. REGENSTEIN, M.D.; and CAROL J. BODICKY, R.N.
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Presented in part November, 1983, at the 34th Annual Meeting of the American Assocation for the Study of Liver Diseases, Chicago, Illinois.

▸Requests for reprints should be addressed to Robert P. Perrillo, MD.; Medical Service (111JC), VA Medical Center; St. Louis, MO 63125.


St. Louis, Missouri


Ann Intern Med. 1984;100(1):43-46. doi:10.7326/0003-4819-100-1-43
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Abrupt increases of alanine transaminase were observed in 6 of 23 non-treated, male homosexuals with chronic hepatitis associated with hepatitis B virus. Before this occurrence, all subjects had hepatitis B e antigen (HBeAg) and elevated DNA polymerase activity. Within 3 months, HBeAg was nondetectable in 3 subjects and elevated DNA polymerase disappeared in 4. These serologic events were not always sustained, however. In 3 subjects, reactivation of hepatitis B virus infection occurred within the subsequent 6-month period. Serologic testing for cytomegalovirus, Epstein-Barr virus, delta agent, and hepatitis B surface antigen (HBsAg) subtype showed that episodes of clearance and reactivation were not explainable by secondary infection with these agents or infection with a different HBsAg subtype. Spontaneous clearance and reactivation of hepatitis B virus infection may commonly occur among male homosexuals with chronic type B hepatitis. These phenomena should be considered when evaluating the need for treatment or interpreting the results of investigations that use anti-viral therapy.

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