title: The HBV DNA cutoff value for discriminating patients with HBeAgnegative chronic hepatitis B from inactive carriers.
abstract: BACKGROUND
  Patients with HBeAg-negative chronic hepatitis B (CHB) has a significantly different prognosis than inactive carriers; there is however, no reliable strategy for accurately differentiating these two disease conditions.
  
  
  OBJECTIVE
  To determine a strategy for discriminating patients with HBeAg-negative CHB from inactive carriers.
  
  
  METHODS
  Consecutive inactive carriers (i.e. HBeAg-negativity, anti-HBe-positivity, normal ALT levels, and HBV DNA < 2000 IU/mL) were enrolled. HBV reactivation was defined as the elevation of the HBV DNA level to ≥ 2000 IU/mL. Patients were classified into true inactive carriers when their HBV DNA levels remained at < 2000 IU/mL or false inactive carriers when their HBV DNA levels increased to ≥ 2000 IU/mL during the first year.
  
  
  RESULTS
  The Mean ± SD age of 208 inactive carriers (140 males) was 47.7 ± 12.6 years. The Mean ± SD serum ALT and HBV DNA levels were 22.8 ± 8.6 IU/L and 360 ± 482 IU/mL, respectively. HBV reactivation developed in 41 (19.7%) patients during the first year. Baseline HBV DNA and ALT levels differed significantly between true inactive and false inactive carriers. The AUROCs of the baseline ALT and HBV DNA levels for predicting a false inactive carrier were 0.609 and 0.831, respectively. HBV reactivation developed more often in patients with a baseline HBV DNA level of ≥ 200 IU/mL than in those with a baseline HBV DNA level of < 200 IU/mL during a Mean ± SD follow-up of 622 ± 199 days.
  
  
  CONCLUSIONS
  The HBV DNA level was useful for discriminating patients with HBeAg-negative CHB from true inactive carriers. The follow-up strategies applied to inactive carriers need to vary with their HBV DNA levels.
authors.affiliation: Departments of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Eun Sun
authors.initials: ES
authors.lastname: Kim
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Bora
authors.initials: B
authors.lastname: Keum
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyonggin
authors.initials: H
authors.lastname: A
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Kim
authors.forename: Yoon Tae
authors.initials: YT
authors.lastname: Jeen
authors.forename: Hong Sik
authors.initials: HS
authors.lastname: Lee
authors.forename: Hoon Jai
authors.initials: HJ
authors.lastname: Chun
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um
authors.forename: Chang
authors.initials: C
authors.lastname: Duck Kim
authors.forename: Ho Sang
authors.initials: HS
authors.lastname: Ryu
references.citation: Hepatology. 1981 Sep-Oct;1(5):386-91
references.pmid: 7030903
references.citation: Gastroenterology. 2006 Mar;130(3):678-86
references.pmid: 16530509
references.citation: Lancet. 1981 Oct 10;2(8250):765-8
references.pmid: 6116901
references.citation: Gastroenterology. 2004 Sep;127(3):756-63
references.pmid: 15362032
references.citation: J Viral Hepat. 2002 May;9(3):229-34
references.pmid: 12010512
references.citation: JAMA. 2006 Jan 4;295(1):65-73
references.pmid: 16391218
references.citation: J Gastroenterol Hepatol. 1997 Oct;12(9-10):S218-22
references.pmid: 9407340
references.citation: Semin Liver Dis. 2006 May;26(2):130-41
references.pmid: 16673291
references.citation: Am J Gastroenterol. 2002 Feb;97(2):406-12
references.pmid: 11866280
references.citation: Am J Gastroenterol. 2009 Jul;104(7):1693-9
references.pmid: 19455130
references.citation: Hepatology. 2009 May;49(5 Suppl):S4-S12
references.pmid: 19399804
references.citation: N Engl J Med. 2002 Apr 18;346(16):1221-31
references.pmid: 11961152
references.citation: Clin Gastroenterol Hepatol. 2006 Aug;4(8):936-62
references.pmid: 16844425
references.citation: J Hepatol. 2008 Dec;49(6):884-91
references.pmid: 18674840
references.citation: J Gastroenterol Hepatol. 2008 Jul;23(7 Pt 1):1082-8
references.pmid: 18707599
references.citation: Hepatology. 2007 May;45(5):1193-8
references.pmid: 17464993
references.citation: J Hepatol. 2008 Feb;48(2):335-52
references.pmid: 18096267
references.citation: Liver Int. 2007 Jun;27(5):607-11
references.pmid: 17498244
references.citation: J Hepatol. 2009 Feb;50(2):227-42
references.pmid: 19054588
references.citation: J Viral Hepat. 2001 Sep;8(5):311-21
references.pmid: 11555188
references.citation: Hepatology. 2001 Oct;34(4 Pt 1):617-24
references.pmid: 11584355
references.citation: J Hepatol. 2003;39 Suppl 1:S160-3
references.pmid: 14708696
references.citation: J Hepatol. 2002 Feb;36(2):263-70
references.pmid: 11830339
references.citation: Hepatology. 2002 Jun;35(6):1522-7
references.pmid: 12029639