title: Natural history of chronic hepatitis B virus infection based on laboratory testing.
abstract: BACKGROUND
  Understanding of the natural history of chronic HBV infection is useful for presenting the optimal management of chronic HBV infection. The aim of this study was to evaluate the natural history of chronic hepatitis B infection.
  
  
  METHODS
  In this cross sectional study, 219 untreated chronic hepatitis B patients from Jan. 2010 to Aug. 2012 were included. The subjects were classified in four groups based on serological, biochemical and molecular testing, Serological tests for HBeAg and HBeAb were performed by ELISA method. HBV DNA viral loads were detected by using Light Cycler instrument and ALT/AST levels were assessed by automatic analyzer.
  
  
  RESULTS
  The majority of subjects (94.1%) were HBeAg negative. Of 13 HBeAg positive patients, 5 (2.3%) and 8(3.7%) were considered as immunetolerant and immune reactive, respectively. Of 206 HBeAg negative patients, there were 142 (64.8%) patients in inactive or low replicative phase and 64(29.2%) were in HBeAg negative chronic hepatitis B phase.
  
  
  CONCLUSIONS
  The lowest rate of subjects were in immunetolerant phase and most of them had above 20 years old that confirmed successful neonatal vaccines in our country. The highest rate of chronic HBV infected patients were in low replicative phase of chronic hepatitis B infection. Although, it is not recommended to treat these patients, but liver function and also liver biopsy should be considered in patients above 40 years of age.
authors.affiliation: Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine , Tehran, Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Sharifi
keywords: Chronic Hepatitis B; HBV viral load; HBeAg; Natural history; Real time PCR