Serum hepatitis B virus DNA levels and liver histology in inactive HBsAg carriers.
OBJECTIVE
A recent NIH research workshop on hepatitis B virus (HBV) revisited the definition of healthy HBsAg carriers. The new definition inactive surface antigen (HBsAg) carriers includes an estimated serum HBV DNA level below 105 copies/ml. However, this cut-off value needs to be confirmed.


METHODS
Eighty-five consecutive patients, HBsAg-positive/HBeAg-negative with persistently normal alanine aminotransferase (ALT) and undetectable serum HBV DNA with standard assay (Versant HBV DNA Assay (bDNA), Bayer) were prospectively followed for 3.2+/-2.6 (range 0.5-11) years; 58 underwent a liver biopsy. Serum HBV DNA was quantified with a sensitive polymerase chain reaction assay (Cobas Amplicor HBV Monitor, Roche) (sensitivity 200 copies/ml), and liver histology was assessed using the Ishak scoring system.


RESULTS
The median serum HBV DNA level was 1300 copies/ml (<200-179 x 10(3) copies/ml), 16% of the subjects had no detectable serum HBV DNA and 98% had levels below 10(5) copies/ml. Histologic lesions were mild (total score <7) in all cases. Loss of HBsAg was observed in three patients, three patients experienced a transient increase in ALT (<2 x upper limit of normal), and serum HBV DNA levels remained stable (1-6 years) in 97% of the 38 patients retested.


CONCLUSIONS
In our study of inactive HBsAg carriers, the median serum HBV DNA level was 1300 copies/ml, the serum HBV DNA level was below 10(5) copies/ml in 98% of the patients, and remained stable; histological lesions were mild in all cases.
Martinot-Peignoux
Michelle
M
Unité de Recherche INSERM U-481, Centre de Recherche Claude Bernard sur les Hépatites Virales and Service d'Hépatologie, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110 Clichy, France. martinot@bichat.inserm.fr
Boyer
Nathalie
N
Colombat
Magalie
M
Akremi
Rahouda
R
Pham
Bach-Nga
BN
Ollivier
Stephan
S
Castelnau
Corinne
C
Valla
Donimique
D
Degott
Claude
C
Marcellin
Patrick
P
D000328:Adult; D002353:Carrier State / Q000097:blood* / Q000473:pathology*; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D018628:Gene Dosage; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens