Viral level is an indicator of long-term outcome of hepatitis B virus e antigen-negative carriers with persistently normal serum alanine aminotransferase levels

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J Viral Hepat. 2011 Jul;18(7):e191-9. doi: 10.1111/j.1365-2893.2010.01427.x.

Epub 2011 Jan 11.

Viral level is an indicator of long-term outcome of hepatitis B virus e

antigen-negative carriers with persistently normal serum alanine

aminotransferase levels.

Nakazawa T, Shibuya A, Takeuchi A, Shibata Y, Hidaka H, Okuwaki Y, Takada J,

Tanaka Y, Watanabe M, Minamino T, Sakurai K, Koizumi W.

Source

Department of Gastroenterology, Kitasato University East Hospital, Sagamihara

Nakazawa Medical Clinic, Sagamihara Department of Clinical Laboratory, Kitasato

University East Hospital, Sagamihara, Japan.

Abstract

Summary.  The association between viral level and the long-term outcomes of

hepatitis B virus (HBV) carriers who test negative for hepatitis B virus e

antigen (HBeAg) but have persistently normal serum alanine aminotransferase

levels (PNALT) remains unclear. We examined hepatocarcinogenesis, hepatitis

reactivation, predictive factors and the time course of HBV DNA levels during

follow-up in 104 HBeAg-negative Japanese carriers with PNALT. During a mean

follow-up period of 6.4 ± 3.4 years, 5 patients (4.8%) had

hepatocarcinogenesis and 14 (13.5%) had hepatitis reactivation. At 5 and

10 years, the cumulative rates of hepatocarcinogenesis were 2.4% and 9.9%,

while those of hepatitis activation were 13.7% and 15.5%, respectively. An HBV

DNA level of ≥5 log(10)  copies/mL was the sole predictor of

hepatocarcinogenesis with a univariate analysis. An HBV DNA level of

≥5 log(10)  copies/mL and an alanine aminotransferase (ALT) level of >20

to ≤40 IU/L were independent predictors of hepatitis reactivation in a

model. Because there was no association between hepatocarcinogenesis and ALT

activity, the HBV DNA level was considered an essential predictor. In addition,

the baseline HBV DNA level was related to the future level and was not subject

to wide fluctuations. Our results showed that an HBV DNA level of ≥5 log(10)

 copies/mL predicts subsequent hepatocarcinogenesis and hepatitis reactivation

in HBeAg-negative carriers with PNALT. As the baseline HBV DNA level reflects

the future level, appropriate clinical management according to the viral level

is expected to decrease future risk.

© 2011 Blackwell Publishing Ltd.

PMID: 21692932 [PubMed - in process]

[Guest guest]

J Viral Hepat. 2011 Jul;18(7):e191-9. doi: 10.1111/j.1365-2893.2010.01427.x.

Epub 2011 Jan 11.

Viral level is an indicator of long-term outcome of hepatitis B virus e

antigen-negative carriers with persistently normal serum alanine

aminotransferase levels.

Nakazawa T, Shibuya A, Takeuchi A, Shibata Y, Hidaka H, Okuwaki Y, Takada J,

Tanaka Y, Watanabe M, Minamino T, Sakurai K, Koizumi W.

Source

Department of Gastroenterology, Kitasato University East Hospital, Sagamihara

Nakazawa Medical Clinic, Sagamihara Department of Clinical Laboratory, Kitasato

University East Hospital, Sagamihara, Japan.

Abstract

Summary.  The association between viral level and the long-term outcomes of

hepatitis B virus (HBV) carriers who test negative for hepatitis B virus e

antigen (HBeAg) but have persistently normal serum alanine aminotransferase

levels (PNALT) remains unclear. We examined hepatocarcinogenesis, hepatitis

reactivation, predictive factors and the time course of HBV DNA levels during

follow-up in 104 HBeAg-negative Japanese carriers with PNALT. During a mean

follow-up period of 6.4 ± 3.4 years, 5 patients (4.8%) had

hepatocarcinogenesis and 14 (13.5%) had hepatitis reactivation. At 5 and

10 years, the cumulative rates of hepatocarcinogenesis were 2.4% and 9.9%,

while those of hepatitis activation were 13.7% and 15.5%, respectively. An HBV

DNA level of ≥5 log(10)  copies/mL was the sole predictor of

hepatocarcinogenesis with a univariate analysis. An HBV DNA level of

≥5 log(10)  copies/mL and an alanine aminotransferase (ALT) level of >20

to ≤40 IU/L were independent predictors of hepatitis reactivation in a

model. Because there was no association between hepatocarcinogenesis and ALT

activity, the HBV DNA level was considered an essential predictor. In addition,

the baseline HBV DNA level was related to the future level and was not subject

to wide fluctuations. Our results showed that an HBV DNA level of ≥5 log(10)

 copies/mL predicts subsequent hepatocarcinogenesis and hepatitis reactivation

in HBeAg-negative carriers with PNALT. As the baseline HBV DNA level reflects

the future level, appropriate clinical management according to the viral level

is expected to decrease future risk.

© 2011 Blackwell Publishing Ltd.

PMID: 21692932 [PubMed - in process]