title: Changes in viral load and HBsAg and HBeAg status with age in HBV chronic carriers in The Gambia.
abstract: BACKGROUND
  Little is known about changes in hepatitis B viral load (HBV DNA) in relation to age in Africa. The aim of this study is to determine the natural course of HBV chronic infection, particularly in relation to sequential changes in serum HBV DNA levels and hepatitis B surface (HBsAg) antigen/hepatitis e antigen (HBeAg) status by age.
  
  
  METHODS
  The study was conducted on 190 HBV chronic carriers, aged 1-19 years who were followed for 19 years. 160, 99 and 123 were traced at 5, 9 and 19 years later. All available samples were tested for HBsAg and HBeAg, whilst 170, 61, 63 and 81 were tested for HBV DNA at the baseline, and at 5, 9 and 19 years following recruitment.
  
  
  RESULTS
  In general HBeAg which correlated with high levels of HBV DNA was lost at a much faster rate than HBsAg. 86% of the carriers who were recruited at the age of 1-4 yrs lost HBeAg by the age of 19 years compared to 30% who lost HBsAg. HBeAg negative carriers had serum HBV DNA levels of < 105 copies per mL, HBV DNA positivity declined from 100% in 1-4 yrs old carriers at recruitment to 62.5%,60% and 88% at 5, 9 and 19 years respectively following recruitment.
  
  
  CONCLUSIONS
  After 19 years of follow up, the majority of HBV surface antigen carriers had lost HBeAg positivity and had low levels of viral replication. However small proportions (10-20%) retained HBeAg and continue to have high levels of viral replication.
authors.affiliation: Medical Research Council Laboratories, Atlantic Boulevard, PO Box 273, Banjul, The Gambia. mmendy@mrc.gm
authors.forename: Maimuna E
authors.initials: ME
authors.lastname: Mendy
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: McConkey
authors.forename: Marianne A B
authors.initials: MA
authors.lastname: Sande van der
authors.forename: Sarah
authors.initials: S
authors.lastname: Crozier
authors.forename: Steve
authors.initials: S
authors.lastname: Kaye
authors.forename: David
authors.initials: D
authors.lastname: Jeffries
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Hall
authors.forename: Hilton C
authors.initials: HC
authors.lastname: Whittle
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002353:Carrier State / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005714:Gambia; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000821:virology*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens