Clinical

Progression to cirrhosis possible in inactive carriers of hepatitis B

Last Updated: 2009-07-30 19:30:45 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Although uncommon, progression to cirrhosis is possible in inactive carriers of hepatitis B virus (HBV), according to a report in the July issue of The American Journal of Gastroenterology.

Few studies have followed-up inactive HBsAg carriers, note Dr. Chia-Ming Chu and Dr. Yun-Fan Liaw from Chang Gung University College of Medicine, Taipei, Taiwan explored the long-term outcome and risk of progression to cirrhosis in 1965 anti-HBe-positive HBsAg carriers with normal alanine aminotransferase (ALT) levels.

The annual rate of reactivation of HBV was 1.55%, the authors report, and the annual rate of the development of cirrhosis in patients with reactivated hepatitis B was estimated to be 0.25%.

Factors associated with progression to cirrhosis in patients with reactivated of hepatitis B included advanced age at study entry and male gender.

"In the high-prevalence areas of HBV, although the majority of inactive carriers may remain in the inactive carrier state with a very favorable outcome, the so-called inactive carrier state cannot be generally viewed as an innocent long-lasting condition of good prognosis," the investigators say.

They estimate that the "cumulative probability of cirrhosis is ~10% after 20-25 years of follow-up."

"Regular follow-up with appropriate monitoring aimed at prompt diagnosis of reactivation of hepatitis B and early initiation of anti-viral treatment where appropriate is necessary," the authors conclude.

Am J Gastroenterol 2009;104:1693-1699.