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Hepatitis B virus (HBV) infection causes a chronic inflammatory condition involving the liver. It is characterized by fever, jaundice, and an enlarged liver. In a certain number of cases, hepatitis B progresses to cirrhosis, a much more serious, often fatal, degenerative liver condition; in other cases, particularly in patients with permanent termination of HBV replication, spontaneous remission occurs. Previous studies on heterogeneous patient populations have suggested that some combination of parameters may allow prediction of which patients will improve and which will worsen, but experimental conditions have not been standardized well enough to draw firm conclusions. To clarify this issue, a long-term study assessed 105 HBV-infected patients without cirrhosis (at time of diagnosis); they were monitored for periods ranging from 1 to 16 years, and underwent periodic liver biopsies. During an average follow-up period of 3.7 years, 20 percent of the patients developed cirrhosis (calculated annual incidence 5.9 percent). Patients with chronic active hepatitis and bridging hepatic necrosis (a lesion seen in biopsy specimens) were significantly more likely to develop cirrhosis than patients with either the chronic active or chronic persistent forms of the disease. Multivariate statistical methods revealed that older age, presence of bridging hepatic necrosis, and persistence of hepatitis B DNA in the blood predicted the development of cirrhosis. (Consumer Summary produced by Reliance Medical Information, Inc.)