Hepatitis B Virus Inactive Carriers: Which Follow-up Strategy?

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• The natural history and optimal management of inactive hepatitis B virus (HBV) carriers remain unclear.
• Doubts persist regarding the best approach for managing patients with inactive HBV infection.

Purpose of the Study:

• To evaluate the long-term outcomes in a cohort of patients with inactive hepatitis B virus (HBV) carriers.
• To assess the stability of viral load and alanine transaminase (ALT) levels in inactive HBV carriers over time.

Main Methods:

• Retrospective study of 100 inactive HBV carriers.
• Quarterly monitoring of serum ALT and HBV DNA levels over one year for categorization.
• Quantification of HBV DNA using Cobas TaqMan® and correlation analysis with ALT using Spearman's rank correlation coefficient.

Main Results:

• 100 inactive HBV carriers (53% female, mean age 48.7 years) were followed for a mean of 4.6 years.
• Hepatitis B surface antigen (HBsAg) clearance occurred in 4%, and reactivation in 10%.
• 90% of patients maintained unremarkable viral load and ALT levels; no significant correlation was found between ALT and HBV DNA.

Conclusions:

• Current management strategies based on biochemical and virologic activity appear adequate.
• The lack of correlation between ALT and HBV DNA necessitates caution in assessing management effectiveness.
• The generally benign prognosis for accurately defined inactive HBV carriers warrants further investigation with new diagnostic tools.