Takashi Taida1, Makoto Arai2, Tatsuo Kanda1, Shuhei Hige3, Yoshiyuki Ueno4, Fumio Imazeki5, Namiki Izumi6, Eiji Tanaka7, Noboru Shinkai8, Kentaro Yoshioka9, Yasunari Nakamoto10, Shuhei Nishiguchi11, Masataka Tsuge12, Masanori Abe13, Michio Sata14, Hiroshi Yatsuhashi15, Akio Ido16, Kazuhiko Kita17, Ryousaku Azemoto18, Yoshio Kitsukawa19, Nobuaki Goto20, Osamu Yokosuka1. 1. Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan. 2. Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan. araim-cib@umin.ac.jp. 3. Department of Gastroenterology, Sapporo-Kosei General Hospital, Sapporo, Hokkaido, Japan. 4. Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan. 5. Safety and Health Organization, Chiba University, Chiba, Japan. 6. Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino, Tokyo, Japan. 7. Department of Internal Medicine, Division of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan. 8. Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan. 9. Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University, Toyoake, Aichi, Japan. 10. Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan. 11. Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. 12. Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan. 13. Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Ehime, Japan. 14. Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan. 15. Clinical Research Center, National Hospital Organization (NHO) Nagasaki Medical Center, Omura, Nagasaki, Japan. 16. Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. 17. Department of Gastroenterology, Chiba Kaihin Municipal Hospital, Chiba, Japan. 18. Department of Gastroenterology, Kimitsu Chuo Hospital, Kisarazu, Chiba, Japan. 19. Department of Gastroenterology, Chiba Aoba Municipal Hospital, Chiba, Japan. 20. Department of Gastroenterology, Numazu City Hospital, Numazu, Shizuoka, Japan.
Abstract
BACKGROUND: Hepatitis B e antigen (HBeAg)-negative inactive carriers, the majority of hepatitis B virus (HBV) carriers, are considered to have a good prognosis. The definition of the inactive HBV carrier state has been based on HBV DNA and alanine aminotransferase (ALT) levels. Here we conducted a prospective study involving 18 hospitals to clarify the prognosis of HBeAg-negative inactive carriers. METHODS: Three hundred eighty-eight HBeAg-negative inactive carriers at the baseline were observed prospectively from January 2011 to November 2015. We evaluated the primary end point, defined as the development of cirrhosis, hepatocellular carcinoma (HCC), or liver-related death. Also, we analyzed the factors associated with inactive carrier dropout and markedly increased levels of ALT or HBV DNA or both during the follow-up period. RESULTS: At the baseline, the mean age was 57.5 ± 13.1 years and 42 % of patients were male. No individual developed cirrhosis, HCC, or liver-related death during the follow-up period (1035 ± 252 days). Loss of inactive carrier status was seen in 75 patients (19.3 %). Factors associated with failure to meet the inactive carrier criteria in the multivariate analysis were the levels of ALT (hazard ratio 1.13, 95 % confidence interval 1.07-1.19, p < 0.001), HBV DNA (hazard ratio 2.70, 95 % confidence interval 1.63-4.49, p < 0.001), and γ-glutamyl transpeptidase (hazard ratio 1.01, 95 % confidence interval 1.00-1.02, p = 0.003) at the baseline. CONCLUSIONS: Most inactive carriers in Japan had a good prognosis. However, despite the short observation period, some patients had loss of IC status. The long-term prognosis of inactive carriers remains unclear; therefore, careful follow-up of inactive carriers is needed.
BACKGROUND:Hepatitis B e antigen (HBeAg)-negative inactive carriers, the majority of hepatitis B virus (HBV) carriers, are considered to have a good prognosis. The definition of the inactive HBV carrier state has been based on HBV DNA and alanine aminotransferase (ALT) levels. Here we conducted a prospective study involving 18 hospitals to clarify the prognosis of HBeAg-negative inactive carriers. METHODS: Three hundred eighty-eight HBeAg-negative inactive carriers at the baseline were observed prospectively from January 2011 to November 2015. We evaluated the primary end point, defined as the development of cirrhosis, hepatocellular carcinoma (HCC), or liver-related death. Also, we analyzed the factors associated with inactive carrier dropout and markedly increased levels of ALT or HBV DNA or both during the follow-up period. RESULTS: At the baseline, the mean age was 57.5 ± 13.1 years and 42 % of patients were male. No individual developed cirrhosis, HCC, or liver-related death during the follow-up period (1035 ± 252 days). Loss of inactive carrier status was seen in 75 patients (19.3 %). Factors associated with failure to meet the inactive carrier criteria in the multivariate analysis were the levels of ALT (hazard ratio 1.13, 95 % confidence interval 1.07-1.19, p < 0.001), HBV DNA (hazard ratio 2.70, 95 % confidence interval 1.63-4.49, p < 0.001), and γ-glutamyl transpeptidase (hazard ratio 1.01, 95 % confidence interval 1.00-1.02, p = 0.003) at the baseline. CONCLUSIONS: Most inactive carriers in Japan had a good prognosis. However, despite the short observation period, some patients had loss of IC status. The long-term prognosis of inactive carriers remains unclear; therefore, careful follow-up of inactive carriers is needed.
Entities:
Keywords:
Chronic hepatitis; Hepatitis B virus; Inactive carrier; Prognosis
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