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Journal of Gastroenterology
January 2017, Volume 52, Issue 1, pp 113–122
The prognosis of hepatitis B inactive carriers in Japan: a multicenter prospective study
Authors
Authors and affiliations
Takashi TaidaMakoto AraiEmail authorTatsuo KandaShuhei HigeYoshiyuki UenoFumio ImazekiNamiki IzumiEiji TanakaNoboru ShinkaiKentaro YoshiokaYasunari NakamotoShuhei NishiguchiMasataka TsugeMasanori AbeMichio Sata
Takashi Taida 1
Makoto Arai 1Email author
Tatsuo Kanda 1
Shuhei Hige 2
Yoshiyuki Ueno 3
Fumio Imazeki 4
Namiki Izumi 5
Eiji Tanaka 6
Noboru Shinkai 7
Kentaro Yoshioka 8
Yasunari Nakamoto 9
Shuhei Nishiguchi 10
Masataka Tsuge 11
Masanori Abe 12
Michio Sata 13
Hiroshi Yatsuhashi 14
Akio Ido 15
Kazuhiko Kita 16
Ryousaku Azemoto 17
Yoshio Kitsukawa 18
Nobuaki Goto 19
Osamu Yokosuka 1
1.Department of Gastroenterology and Nephrology, Graduate School of MedicineChiba UniversityChibaJapan
2.Department of GastroenterologySapporo-Kosei General HospitalSapporoJapan
3.Department of Gastroenterology, Faculty of MedicineYamagata UniversityYamagataJapan
4.Safety and Health OrganizationChiba UniversityChibaJapan
5.Department of Gastroenterology and HepatologyMusashino Red Cross HospitalMusashinoJapan
6.Department of Internal Medicine, Division of GastroenterologyShinshu University School of MedicineMatsumotoJapan
7.Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
8.Department of Liver, Biliary Tract and Pancreas DiseasesFujita Health UniversityToyoakeJapan
9.Second Department of Internal Medicine, Faculty of Medical SciencesUniversity of FukuiFukuiJapan
10.Division of Hepatobiliary and Pancreatic Disease, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
11.Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health ScienceHiroshima UniversityHiroshimaJapan
12.Departments of Gastroenterology and MetabologyEhime University Graduate School of MedicineMatsuyamaJapan
13.Division of Gastroenterology, Department of MedicineKurume University School of MedicineKurumeJapan
14.Clinical Research CenterNational Hospital Organization (NHO) Nagasaki Medical CenterOmuraJapan
15.Digestive and Lifestyle DiseasesKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
16.Department of GastroenterologyChiba Kaihin Municipal HospitalChibaJapan
17.Department of GastroenterologyKimitsu Chuo HospitalKisarazuJapan
18.Department of GastroenterologyChiba Aoba Municipal HospitalChibaJapan
19.Department of GastroenterologyNumazu City HospitalNumazuJapan
Original Article—Liver, Pancreas, and Biliary Tract
First Online:
15 June 2016
DOI: 10.1007/s00535-016-1229-6
Cite this article as:
Taida, T., Arai, M., Kanda, T. et al. J Gastroenterol (2017) 52: 113. doi:10.1007/s00535-016-1229-6
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Abstract
Background
Hepatitis B e antigen (HBeAg)-negative inactive carriers, the majority of hepatitis B virus (HBV) carriers, are considered to have a good prognosis. The definition of the inactive HBV carrier state has been based on HBV DNA and alanine aminotransferase (ALT) levels. Here we conducted a prospective study involving 18 hospitals to clarify the prognosis of HBeAg-negative inactive carriers.
Methods
Three hundred eighty-eight HBeAg-negative inactive carriers at the baseline were observed prospectively from January 2011 to November 2015. We evaluated the primary end point, defined as the development of cirrhosis, hepatocellular carcinoma (HCC), or liver-related death. Also, we analyzed the factors associated with inactive carrier dropout and markedly increased levels of ALT or HBV DNA or both during the follow-up period.
Results
At the baseline, the mean age was 57.5 ± 13.1 years and 42 % of patients were male. No individual developed cirrhosis, HCC, or liver-related death during the follow-up period (1035 ± 252 days). Loss of inactive carrier status was seen in 75 patients (19.3 %). Factors associated with failure to meet the inactive carrier criteria in the multivariate analysis were the levels of ALT (hazard ratio 1.13, 95 % confidence interval 1.07–1.19, p < 0.001), HBV DNA (hazard ratio 2.70, 95 % confidence interval 1.63–4.49, p < 0.001), and γ-glutamyl transpeptidase (hazard ratio 1.01, 95 % confidence interval 1.00–1.02, p = 0.003) at the baseline.
Conclusions
Most inactive carriers in Japan had a good prognosis. However, despite the short observation period, some patients had loss of IC status. The long-term prognosis of inactive carriers remains unclear; therefore, careful follow-up of inactive carriers is need
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