title: Characteristics and course of chronic hepatitis B e antigen-negative infection.
abstract: OBJECTIVE
  To describe the epidemiological, analytical and histological characteristics and clinical course of hepatitis B virus (HBV) carriers with negative HBe antigen.
  
  
  METHODS
  Observational, retrospective cohort study of HBV carriers with negative HBe antigen (2005-2012), with no other causes of liver disease.
  
  
  RESULTS
  One hundred and thirty-eight patients were included, with mean age 40.5±12.2 years; 54% were women, and 38% were of foreign origin; the number of foreign patients significantly increased (P<.001) over the years. Transaminases were normal in nearly 75% and HBV-DNA was <2,000IU/ml in 56% of patients at diagnosis. There was a gradual decrease in HBV-DNA levels in inactive carriers over the study period. Fibrosis study was performed in 47% of patients by Fibroscan®or liver biopsy: 55.4% normal histology and 6.1% cirrhosis. Just over three quarters of patients (77.77%) were inactive carriers. Treatment was required in 15.5% of patients (20% because of cirrhosis and 80% HBeAg-negative chronic hepatitis B). Five patients cleared HBsAg (annual rate .94%), all of whom presented HBV-DNA <2,000IU/ml at diagnosis. Five patients developed complications (3.6%), 4 of them hepatocellular carcinoma (HCC), of which only 2 had cirrhosis. There was 1 HBV-related death (.72%).
  
  
  CONCLUSIONS
  Among HBV carriers with negative HBe antigen, inactive HBs-Ag carriers are predominant. HBV-DNA gradually decreases in the first few years after diagnosis. Morbidity and mortality are low, especially if glutamic pyruvic transaminase (GPT) is normal and HBV-DNA levels are low at diagnosis. Treatment is needed in a considerable number of patients. HCC is the most frequent complication, even in the absence of cirrhosis.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Virgen de la Salud, Toledo, España; Servicio de Aparato Digestivo, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España. Electronic address: antonio.guardiola@salud.madrid.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Guardiola Arévalo
authors.affiliation: Servicio de Aparato Digestivo, Hospital Virgen de la Salud, Toledo, España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Gómez Rodríguez
authors.affiliation: Servicio de Aparato Digestivo, Hospital Virgen de la Salud, Toledo, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Romero Gutiérrez
authors.affiliation: Servicio de Aparato Digestivo, Hospital Virgen de la Salud, Toledo, España.
authors.forename: Ana Zaida
authors.initials: AZ
authors.lastname: Gómez Moreno
authors.affiliation: Servicio de Aparato Digestivo, Hospital Virgen de la Salud, Toledo, España.
authors.forename: Almudena
authors.initials: A
authors.lastname: García Vela
authors.affiliation: Anatomía Patológica, Hospital Virgen de la Salud, Toledo, España.
authors.forename: Raquel
authors.initials: R
authors.lastname: Sánchez Simón
authors.affiliation: Microbiología, Hospital Virgen de la Salud, Toledo, España.
authors.forename: Cesar
authors.initials: C
authors.lastname: Gómez Hernando
authors.affiliation: Universidad Autónoma de Madrid, Madrid, España.
authors.forename: Eva María
authors.initials: EM
authors.lastname: Andrés Esteban
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D012189:Retrospective Studies
chemical_list: D006513:Hepatitis B e Antigens
keywords: ADN; Antígeno HBe(–); DNA; Glutamic pyruvic transaminase; Glutámico pirúvico transaminasa; HBe antigen-negative chronic hepatitis; Hepatitis B virus; Hepatitis crónica antígeno HBe(–); Negative HBe antigen; Virus de la hepatitis B