title: Detection of hepatitis B activity in HBeAg-negative carriers with normal aminotransferase levels in central Brazil.
abstract: BACKGROUND AND RATIONALE FOR THE STUDY: Hepatitis B virus (HBV) chronic infection may follow a benign course with low risk of cirrhosis or liver cancer. As differentiation of inactive status from HBeAg-negative chronic hepatitis B is often challenging, monitoring of inactive HBV carriers is important to detect viral relapse or formerly undetected activity. The incidence of hepatitis activity in HBeAg-negative carriers with normal aminotransferases was examined by retrospective analysis of a cohort of carriers who had been followed-up at a hospital in Central Brazil. All patients had remained free of evidence of liver disease and maintained normal aminotransferase levels throughout the first year of follow-up. The incidence density of chronic HBV activity was determined and an incidence curve was constructed using the Kaplan-Meier method. Cox regression models were developed to identify for surrogate markers of activity.
  
  
  RESULTS
  Among the 224 patients who comprised the cohort, chronic HBV activity was detected in 30 during followup. The incidence density of activity was 11.8 per 100 person-years (95% confidence interval: 8.3-16.9). The results of Cox regression analysis indicated that chronic HBV activity was associated with entrance in the latter years of the period examined (p = 0.001) and initial normal aspartate aminotransferase (AST) levels close to the upper-normal value (p = 0.022).
  
  
  CONCLUSIONS
  Normal AST levels near the upper-normal value may be an indicator of relapse or previously undetected activity, and should thus be monitored closely in HBeAg-negative HBV carriers, in whom risk of relapse should remain an important managing consideration.
authors.affiliation: Hospital Universitário Júlio Muller, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso, Brazil.
authors.forename: Flávio V
authors.initials: FV
authors.lastname: Barbosa-Júnior
authors.affiliation: Hospital Universitário Júlio Muller, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso, Brazil.
authors.forename: Rafaela de L P
authors.initials: Rde L
authors.lastname: Sanchez-Lermen
authors.affiliation: Hospital Universitário Júlio Muller, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso, Brazil.
authors.forename: Karina de A
authors.initials: Kde A
authors.lastname: Vieira
authors.affiliation: Hospital Universitário Júlio Muller, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso, Brazil.
authors.forename: Renata V de
authors.initials: RV
authors.lastname: Oliveira
authors.affiliation: Hospital Universitário Júlio Muller, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso, Brazil.
authors.forename: Francisco J D
authors.initials: FJ
authors.lastname: Souto
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006513:Hepatitis B e Antigens; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase