title: Characteristics of an outpatient chronic hepatitis B virus infection cohort.
abstract: OBJECTIVE
  To characterize a chronic hepatitis B cohort based on initial and follow-up clinical evaluations.
  
  
  METHODS
  A retrospective and descriptive analysis of clinical and laboratory data from chronic HBsAg adult carriers, without HIV, unexposed to treatment, with at least two outpatient visits, between February 2006 and November 2012. Fisher´s exact test, χ², Wilcoxon, Spearman, multiple comparisons and Kappa tests were applied, the level of significance adopted was 5%, with a 95% confidence interval.
  
  
  RESULTS
  175 patients with mean age of 42.95±12.53 years were included: 93 (53.1%) were men, 152 (86.9%) were negative for hepatitis B e-antigen (HBeAg), 3 (1.7%) had hepatitis C coinfection, 15 (8.6%) had cirrhosis, and 2 (1.1%) had hepatocellular carcinoma. Genotype A predominated. Sixty-six patients (37.7%) had active hepatitis, 6 (3.4%) presented immune tolerance, and 38 (21.7%) were inactive carriers. Exacerbations and/or viral breakthrough were detected in 16 patients (9.1%). In 32 patients (18.3%), hepatitis B virus DNA remained persistently elevated and alanine aminotransferase levels were normal, whereas in 17 (9.7%), there was low hepatitis B virus DNA and alterated alanine aminotransferase. If only initial alanine aminotransferase and hepatitis B virus DNA values were considered, 15 cases of active hepatitis would not have been detected. Advanced fibrosis was more common in HBeAg-positive patients, and it was significantly associated with transaminases, hepatitis B virus DNA, and age.
  
  
  CONCLUSIONS
  Many patients had active hepatitis, but almost 25%, who were HBeAg non-reactive, were only identified because of combined analyses of the hepatitis B virus DNA and transaminases levels, sometimes associated with histological data, after clinical follow-up.
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Danyenne Rejane de
authors.initials: DR
authors.lastname: Assis
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Simone de Barros
authors.initials: Sde B
authors.lastname: Tenore
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: João Renato Rebello
authors.initials: JR
authors.lastname: Pinho
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: David Salomão
authors.initials: DS
authors.lastname: Lewi
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Paulo Roberto Abrão
authors.initials: PR
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001706:Biopsy; D002353:Carrier State / Q000097:blood; D015331:Cohort Studies; D004279:DNA, Viral / Q000235:genetics; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000276:immunology / Q000473:pathology* / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000276:immunology / Q000473:pathology*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010045:Outpatients; D012189:Retrospective Studies; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase