DNA & Liver Histology vs. Inactive HBsAg Carriers

liver411

APRIL  2002

VIRAL HEPATITIS B-Serum Hepatitis B Virus DNA Levels and Liver Histology in Inactive HBsAg Carriers



M. Martinot-Peignoux (1) , N. Boyer (1), M. Colombat (2), R. Akremi (1), B.N. Pham (3), S. Ollivier (1), C. Castelnau (1), D. Valla (1), C. Degott (2), P. Marcellin (1)



(1) Unit?de Recherche INSERM U-481, Centre de Recherche Claude Bernard sur les H閜atites Virales and Service d'H閜atologie, H魀ital Beaujon , Clichy, France

(2) Service d'Anatomie-Cytologie Pathologique, H魀ital Beaujon, Clichy, France

(3) Service d'Hematologie et Immunologie, H魀ital Beaujon, Clichy, France



Background/Aims: A recent NIH research workshop on hepatitis B virus (HBV) revisited the definition of healthy HBsAg carriers. The new definition inactive surface antigen (HBsAg) carriers includes an estimated serum HBV DNA level below 105 copies/ml. However, this cut-off value needs to be confirmed.

Methods: Eighty-five consecutive patients, HBsAg-positive/HBeAg-negative with persistently normal alanine aminotransferase (ALT) and undetectable serum HBV DNA with standard assay (Versant HBV DNA Assay (bDNA), Bayer) were prospectively followed for 3.2?.6 (range 0.5-11) years; 58 underwent a liver biopsy. Serum HBV DNA was quantified with a sensitive polymerase chain reaction assay (Cobas Amplicor HBV Monitor, Roche) (sensitivity 200 copies/ml), and liver histology was assessed using the Ishak scoring system.

Results: The median serum HBV DNA level was 1300 copies/ml (<200-179?03 copies/ml), 16% of the subjects had no detectable serum HBV DNA and 98% had levels below 105 copies/ml. Histologic lesions were mild (total score <7) in all cases. Loss of HBsAg was observed in three patients, three patients experienced a transient increase in ALT (<2譽pper limit of normal), and serum HBV DNA levels remained stable (1-6 years) in 97% of the 38 patients retested.

Conclusions: In our study of inactive HBsAg carriers, the median serum HBV DNA level was 1300 copies/ml, the serum HBV DNA level was below 105 copies/ml in 98% of the patients, and remained stable; histological lesions were mild in all cases. (J. Hepatol., 36 , 543-546, 2002)