Hepatitis B in symptomless Danish homosexual men

Area of Science:

• Hepatology
• Virology
• Immunology

Background:

• Hepatitis B virus (HBV) infection is a significant global health concern.
• Asymptomatic carriers of hepatitis B surface antigen (HBsAg) require characterization of liver disease.
• Homosexual men are a population at risk for sexually transmitted infections, including HBV.

Purpose of the Study:

• To characterize the liver disease in asymptomatic homosexual men positive for HBsAg.
• To determine the clinical course and progression of hepatitis B virus infection in this cohort.
• To investigate the potential influence of human immunodeficiency virus (HIV) co-infection on hepatitis B outcomes.

Main Methods:

• Prospective follow-up of 48 asymptomatic homosexual men with positive HBsAg screening.
• Assessment of liver enzyme activity and immunoglobulin G concentrations.
• Liver biopsy in a subset of patients to evaluate histological liver damage.
• Monitoring for the development of acute hepatitis B, chronic hepatitis B (persistent and aggressive), and cirrhosis.
• Serological testing for antibodies against human immunodeficiency virus (HIV).

Main Results:

• Initially, 66% had elevated liver enzymes and 40% had increased immunoglobulin G.
• Liver biopsies revealed acute hepatitis B in 39% and chronic hepatitis B in 61% of those biopsied.
• The observed course included acute hepatitis B (29%), chronic persistent hepatitis B (48%), chronic aggressive hepatitis B (17%), and cirrhosis (6%).
• HIV antibodies were present in 36% of patients, but did not affect the hepatitis B disease course during the study period.

Conclusions:

• Asymptomatic HBsAg-positive homosexual men exhibit a spectrum of liver disease, frequently progressing to chronic hepatitis B or cirrhosis.
• Regular monitoring and liver biopsy are crucial for characterizing liver disease in these individuals.
• Co-infection with HIV did not appear to alter the natural history of hepatitis B in this cohort over the observed period.