Natural course of inactive hepatitis b carriers

Introduction and AimTo investigate the clinical progression of inactive hepatitis b carrier state by defining the development of hepatocellular carcinoma, activation and determination of seroclearance rates in inactive hepatit b carriers.Material and MethodThis retrospective study included all inactive hepatitis B carrier patients with 6 months of follow-up in DEUTF Gastroenterology Outpatient Clinic. The patients treated for chronic HBV, less than 6 months of follow-up patients and chronic liver disease patients are all excluded. Inactive hepatitis B carrier state is defined as negative, very low or undetected levels of HBV-DNA by PCR, normal serum ALT levels, negative serum HBeAg, positive Anti-HBe and mild or no fibrosis in liver biopsy if available.Results502 patients (mean age: 51.9±12) are included in the study. 219 patients (43.6%) are female, 283 patients (56.4%) are male. Average follow up period was 44.5±36,8 (range 6-168) months, average follow up interval period was 6.2 months (1-52 months). In 28 patients (5.6%) high alpha-fetoprotein level and in 49 patients (9.7%) transient high liver function tests are detected. In 5 of the patients (1%) have seroclearance level of 15.3/10.000 patient year and in 13 of the patients have (2.6%) 39.7/10.000 patient year activation is detected. None of the patients developed hepatocellular carcinoma.DiscussionThe prognosis of inactive hepatitis B carrier state is usually benign. The risk of developing HCC is low. However it is significant to have regular follow-ups to monitor activation.Key words: Inactive Hepatitis B, Hepatocellular Carcinoma, Activation, Seroclearance, Monitor