Detection of hepatitis B activity in HBeAg-negative carriers with normal aminotransferase levels in central Brazil
Journal Title: Annals of Hepatology - Year 2015, Vol 14, Issue 4
Abstract
Background and rationale for the study. Hepatitis B virus (HBV) chronic infection may follow a benigncourse with low risk of cirrhosis or liver cancer. As differentiation of inactive status from HBeAg-negative chronic hepatitis B is often challenging, monitoring of inactive HBV carriers is important to detect viral relapse or formerly undetected activity. The incidence of hepatitis activity in HBeAg-negative carriers with normal aminotransferases was examined by retrospective analysis of a cohort of carriers who had been followed-up at a hospital in Central Brazil. All patients had remained free of evidence of liver disease and maintained normal aminotransferase levels throughout the first year of follow-up. The incidence density of chronic HBV activity was determined and an incidence curve was constructed using the Kaplan-Meier method. Cox regression models were developed to identify for surrogate markers of activity. Results. Among the 224 patients who comprised the cohort, chronic HBV activity was detected in 30 during followup. The incidence density of activity was 11.8 per 100 person-years (95% confidence interval: 8.3-16.9). The results of Cox regression analysis indicated that chronic HBV activity was associated with entrance in the latter years of the period examined (p = 0.001) and initial normal aspartate aminotransferase (AST) levels close to the upper-normal value (p = 0.022). Conclusion. Normal AST levels near the upper-normal value may be an indicator of relapse or previously undetected activity, and should thus be monitored closely in HBeAg-negative HBV carriers, in whom risk of relapse should remain an important managing consideration.
Authors and Affiliations
Flávio V. Barbosa-Júnior, Rafaela de L. P. Sanchez-Lermen, Karina de A. Vieira, Renata V. de Oliveira, Francisco J. D. Souto
Keywords
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