Level of Hepatitis B Virus DNA in Inactive rs With Persistently Normal Levels of Alanine Aminotransferase

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http://www.cghjournal.org/article/PIIS154235651000251X/abstract?rss=yes

Clinical Gastroenterology and Hepatology

Volume 8, Issue 6 , Pages 535-540, June 2010

Level of Hepatitis B Virus DNA in Inactive rs With Persistently Normal

Levels of Alanine Aminotransferase

Chia–Ming Chu

AffiliationsReprint requests Address requests for reprints to: Chia-Ming Chu,

MD, Liver Research Unit, Chang Gung Memorial Hospital, 199, Tung Hwa North Road,

Taipei 10591, Taiwan. fax: (886) 3-3272236

, Yi–Cheng Chen, Dar–In Tai, Yun–Fan Liaw

published online 22 March 2010.

Abstract

Background & Aims

Little is known about the level of hepatitis B virus (HBV) DNA in individuals

with chronic, inactive HBV infections. Patients who test positive for the

antibody to hepatitis B e antigen (anti-HBe) and have normal levels of alanine

aminotransferase for more than 10 years have a low risk of HBV reactivation and

are considered to be inactive carriers. We investigated HBV DNA levels in

inactive carriers and identified factors that correlated with this state among

anti-HBe–positive carriers with HBV DNA levels of 104 copies/mL or greater

(5.26 copies/mL = 1 IU/mL).

Methods

HBV DNA levels were assayed in 250 inactive carriers with persistently normal

alanine aminotransferase levels for more than 10 years. Clinical and virologic

features were compared between inactive carriers (with HBV DNA levels ≥104

copies/mL) and age-matched patients with HBe antigen–negative chronic

hepatitis (controls, n = 90).

Results

The median level of HBV DNA among inactive carriers was 3.70 log10 copies/mL

(range, undetectable to 5.98 log10 copies/mL). Ninety (36%) had levels of 104

copies/mL or greater. Compared with control patients, significant differences of

inactive carriers included sex (more female patients), lower HBV DNA levels, and

lower prevalence of genotype C virus and the basal core promoter mutation

T1762/A1764. The prevalence of the precore mutation A1896 was similar between

groups. Multiple logistic regression analyses identified male sex, HBV DNA

levels greater than 105 copies/mL, and the basal core promoter mutation as

independent factors that correlated with active disease.

Conclusions

Nearly 40% of inactive carriers had HBV DNA levels of 104 copies/mL or greater.

Female sex, HBV DNA levels of 104 to 105 copies/mL, and wild-type basal core

promoter correlated with inactive carrier state.

Conflicts of interest The authors disclose the following: Yun-Fan Liaw has

been involved in clinical trials or served as a global advisory board member of

Roche, Bristol-Myers Squibb, GlaxoKline, Novartis, and Gilead Sciences. The

remaining authors disclose no conflicts.

Funding This study was supported by a grant from the National Science Council

of Taiwan (NSC97-2314-B-182-019-MY2).

PII: S1542-3565(10)00251-X

doi:10.1016/j.cgh.2010.03.006

© 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.

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