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Chronic active hepatitis in hepatitis B surface antigen (HBsAg) carriers. The need for liver biopsy
JAMA
|January 3, 1977
Insights
Hepatitis B carriers with normal symptoms can still have severe chronic hepatitis. Persistent abnormal liver enzymes in long-term hepatitis B surface antigen carriers warrant a liver biopsy to assess histologic severity.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Hepatitis B virus (HBV) infection is a global health concern.
- Chronic active hepatitis (CAH) is a progressive liver disease.
- Hepatitis B surface antigen (HBsAg) positivity indicates chronic HBV infection.
Observation:
- Four cases of CAH were identified in HBsAg-positive blood donors.
- These individuals presented with minimal or no overt symptoms.
- Histologic examination revealed the full spectrum of chronic hepatitis.
Findings:
- Clinically silent liver disease can exhibit significant histologic damage.
- Chronic active hepatitis can be present despite a lack of symptoms in HBsAg carriers.
- Liver enzyme abnormalities may not correlate with disease severity in asymptomatic carriers.
Implications:
- Liver biopsy is crucial for evaluating liver health in long-term HBsAg carriers.
- Early detection of severe hepatitis through biopsy can guide treatment decisions.
- This highlights the importance of monitoring HBsAg carriers beyond clinical presentation.
Abstract:
Four cases of chronic active hepatitis were found in hepatitis B surface antigen (HBsAg) positive blood donors. Despite minimal symptoms, the full histologic spectrum of chronic hepatitis was seen. Because clinically occult liver disease can be histologically severe, liver biopsy is indicated when liver enzyme levels are persistently abnormal in long-term HBsAg carriers.