The HBV DNA cutoff value for discriminating patients with HBeAgnegative chronic hepatitis B from inactive carriers |
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Authors: | Kim Eun Sun Seo Yeon Seok Keum Bora Kim Ji Hoon A Hyonggin Yim Hyung Joon Kim Yong Sik Jeen Yoon Tae Lee Hong Sik Chun Hoon Jai Um Soon Ho Duck Kim Chang Ryu Ho Sang |
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Institution: | Departments of Internal Medicine, Korea University College of Medicine, Seoul, Korea. |
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Abstract: | BackgroundPatients with HBeAg-negative chronic hepatitis B (CHB) has a significantly different prognosis than inactive carriers; there is however, no reliable strategy for accurately differentiating these two disease conditions.ObjectivesTo determine a strategy for discriminating patients with HBeAg-negative CHB from inactive carriers.Materials and MethodsConsecutive inactive carriers (i.e. HBeAg-negativity, anti-HBe-positivity, normal ALT levels, and HBV DNA < 2000 IU/mL) were enrolled. HBV reactivation was defined as the elevation of the HBV DNA level to ≥ 2000 IU/mL. Patients were classified into true inactive carriers when their HBV DNA levels remained at < 2000 IU/mL or false inactive carriers when their HBV DNA levels increased to ≥ 2000 IU/mL during the first year.ResultsThe Mean ± SD age of 208 inactive carriers (140 males) was 47.7 ± 12.6 years. The Mean ± SD serum ALT and HBV DNA levels were 22.8 ± 8.6 IU/L and 360 ± 482 IU/mL, respectively. HBV reactivation developed in 41 (19.7%) patients during the first year. Baseline HBV DNA and ALT levels differed significantly between true inactive and false inactive carriers. The AUROCs of the baseline ALT and HBV DNA levels for predicting a false inactive carrier were 0.609 and 0.831, respectively. HBV reactivation developed more often in patients with a baseline HBV DNA level of ≥ 200 IU/mL than in those with a baseline HBV DNA level of < 200 IU/mL during a Mean ± SD follow-up of 622 ± 199 days.ConclusionsThe HBV DNA level was useful for discriminating patients with HBeAg-negative CHB from true inactive carriers. The follow-up strategies applied to inactive carriers need to vary with their HBV DNA levels. |
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Keywords: | Hepatitis B virus Reactivation Inactive carrier |
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