Infectivity in asymptomatic hepatitis B carriers: its correlation with HBeAg/anti-HBe status

Sera collected from 190 asymptomatic HBsAg carriers with varying status of HBe markers were tested for HBV DNA using the slot-blot hybridization method and the results were compared with serum alanine aminotransferase (ALT) levels. No significant difference was observed in the positive rate of serum HBV DNA between patients showing either HBeAg (+)/normal ALT or HBeAg (+)/high ALT. On the other hand, in cases with positive anti-HBe or negative for both HBeAg and anti-HBe, statistically significant differences could be shown in HBV DNA positivity between normal and high ALT subjects. In the group of 100 patients possessing anti-HBe antibody, 50% of the cases with high ALT levels were positive for serum HBV DNA, whereas all of the cases with normal ALT levels were negative for serum HBV DNA (p less than 0.0002). In 21 patients showing HBeAg (-)/anti-HBe(-), HBV DNA could be detected in the serum of 60% of the cases with high ALT levels, but in none of the cases with normal ALT levels (p less than 0.05). Our results suggest that HBeAg alone is a reliable marker in the prediction of infectivity in asymptomatic carriers. In cases showing anti-HBe (+), loss of infectivity could be ascertained if the patient had normal serum ALT, but, continuous viral replication should be suspected in cases with high serum ALT values.