title: [Follow-up of chronic hepatitis B carriers. Serological course and risk of reactivation].
abstract: OBJECTIVE
  To investigate serologic changes and risk of reactivation in hepatitis B chronic carriers.
  
  
  METHODS
  Two hundred chronic HBs-Ag positive patients were included (follow-up greater than 18 months). According to the HBeAg/Anti-HBe status at the moment of inclusion they were classified in 3 groups: I: 40 patients HBeAg positive, II: 158 anti-HBe positive and III: 2 HBeAg/Anti-HBe negatives. All patients were screened in the follow-up for biochemical test, hepatitis B, C and D virus serology, DNA.HBV by hybridization, alpha fetoprotein and abdominal ultrasound.
  
  
  RESULTS
  Mean age was 35 +/- 12 years (14-61), and mean follow-up 71 +/- 35.1 months (18-252). In the follow-up 28 patients in group I seroconverted HBeAg/Anti-HBe, 18 spontaneously (annual rate 10%). In group II four patients out off 158 were DNA HBV positive. Only 3 chronic HBV carriers lost HBsAg and developed Anti-HBs (annual rate 0,25%). Reactivation of viral activity was detected in 13 patients Anti-HBe positive, DNA.HBV negative. HBeAg appeared during reactivation in six, both HBeAg/Anti-HBe were negative in one, and six were unchanged. Reactivation was significantly more frequent in chronic carriers with high GPT activity (13 out off 75, 17.3%) than in patients with normal GPT (0 out off 107, 0%) (p < 0.0005).
  
  
  CONCLUSIONS
  Reactivation of HBV activity is frequent in HBsAg chronic carriers Anti-HBe positive, DNA.HBV negative and who are abnormal GPT levels; these patients should be considered at risk of reactivation. The control in the follow-up of HBV chronic carriers with persistently normal GPT, without advanced liver disease, may not be so frequent. The increased infectiousness during reactivation of HBV activity must be taken account for prophylaxis of HBV infection in chronic carriers contacts.
authors.affiliation: Servico de Aparato Digestivo, Hospital Ntra. Sra. de Aránzazu, San Sebastian.
authors.forename: L
authors.initials: L
authors.lastname: Bujanda
authors.forename: M
authors.initials: M
authors.lastname: García Bengoechea
authors.forename: G
authors.initials: G
authors.lastname: Cilla
authors.forename: I
authors.initials: I
authors.lastname: Gil
authors.forename: J I
authors.initials: JI
authors.lastname: yArenas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002353:Carrier State; D002908:Chronic Disease; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000276:immunology; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens
vernacular_title: Seguimiento del portador crónico de la hepatitis B. Evolución serológica y riesgo de reactivación.