Detection of hepatitis B activity in HBeAg-negative carriers with normal aminotransferase levels in central Brazil

Background and rationale for the study. Hepatitis B virus (HBV) chronic infection may follow a benign course with low risk of cirrhosis or liver cancer. As differentiation of inactive status from HBeAg-negative chronic hepatitis B is often challenging, monitoring of inactive HBV carriers is importan...

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Main Authors: Flávio V. Barbosa-Júnior, Rafaela de L.P. Sanchez-Lermen, Karina de A. Vieira, Renata V. de Oliveira, Francisco J.D. Souto, M.D., Ph.D.
Format: Article
Language:English
Published: Elsevier 2015-07-01
Series:Annals of Hepatology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1665268119311688
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author Flávio V. Barbosa-Júnior
Rafaela de L.P. Sanchez-Lermen
Karina de A. Vieira
Renata V. de Oliveira
Francisco J.D. Souto, M.D., Ph.D.
author_facet Flávio V. Barbosa-Júnior
Rafaela de L.P. Sanchez-Lermen
Karina de A. Vieira
Renata V. de Oliveira
Francisco J.D. Souto, M.D., Ph.D.
author_sort Flávio V. Barbosa-Júnior
collection DOAJ
description Background and rationale for the study. Hepatitis B virus (HBV) chronic infection may follow a benign course with low risk of cirrhosis or liver cancer. As differentiation of inactive status from HBeAg-negative chronic hepatitis B is often challenging, monitoring of inactive HBV carriers is important to detect viral relapse or formerly undetected activity. The incidence of hepatitis activity in HBeAg-negative carriers with normal aminotransferases was examined by retrospective analysis of a cohort of carriers who had been followed-up at a hospital in Central Brazil. All patients had remained free of evidence of liver disease and maintained normal aminotransferase levels throughout the first year of follow-up. The incidence density of chronic HBV activity was determined and an incidence curve was constructed using the Kaplan-Meier method. Cox regression models were developed to identify for surrogate markers of activity.Results. Among the 224 patients who comprised the cohort, chronic HBV activity was detected in 30 during follow-up. The incidence density of activity was 11.8 per 100 person-years (95% confidence interval: 8.3-16.9). The results of Cox regression analysis indicated that chronic HBV activity was associated with entrance in the latter years of the period examined (p = 0.001) and initial normal aspartate aminotransferase (AST) levels close to the upper-normal value (p = 0.022).Conclusion. Normal AST levels near the upper-normal value may be an indicator of relapse or previously undetected activity, and should thus be monitored closely in HBeAg-negative HBV carriers, in whom risk of relapse should remain an important managing consideration.
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spelling doaj.art-7a6f0105baac4f36af9c0cbd487a3ec42022-12-21T22:30:33ZengElsevierAnnals of Hepatology1665-26812015-07-01144470476Detection of hepatitis B activity in HBeAg-negative carriers with normal aminotransferase levels in central BrazilFlávio V. Barbosa-Júnior0Rafaela de L.P. Sanchez-Lermen1Karina de A. Vieira2Renata V. de Oliveira3Francisco J.D. Souto, M.D., Ph.D.4Hospital Universitario Júlio Muller, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso, BrazilHospital Universitario Júlio Muller, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso, BrazilHospital Universitario Júlio Muller, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso, BrazilHospital Universitario Júlio Muller, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso, BrazilCorrespondence and reprint request:; Hospital Universitario Júlio Muller, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso, BrazilBackground and rationale for the study. Hepatitis B virus (HBV) chronic infection may follow a benign course with low risk of cirrhosis or liver cancer. As differentiation of inactive status from HBeAg-negative chronic hepatitis B is often challenging, monitoring of inactive HBV carriers is important to detect viral relapse or formerly undetected activity. The incidence of hepatitis activity in HBeAg-negative carriers with normal aminotransferases was examined by retrospective analysis of a cohort of carriers who had been followed-up at a hospital in Central Brazil. All patients had remained free of evidence of liver disease and maintained normal aminotransferase levels throughout the first year of follow-up. The incidence density of chronic HBV activity was determined and an incidence curve was constructed using the Kaplan-Meier method. Cox regression models were developed to identify for surrogate markers of activity.Results. Among the 224 patients who comprised the cohort, chronic HBV activity was detected in 30 during follow-up. The incidence density of activity was 11.8 per 100 person-years (95% confidence interval: 8.3-16.9). The results of Cox regression analysis indicated that chronic HBV activity was associated with entrance in the latter years of the period examined (p = 0.001) and initial normal aspartate aminotransferase (AST) levels close to the upper-normal value (p = 0.022).Conclusion. Normal AST levels near the upper-normal value may be an indicator of relapse or previously undetected activity, and should thus be monitored closely in HBeAg-negative HBV carriers, in whom risk of relapse should remain an important managing consideration.http://www.sciencedirect.com/science/article/pii/S1665268119311688Alanine aminotransferaseAspartate aminotransferaseCirrhosisInactive carrierHBVCohort
spellingShingle Flávio V. Barbosa-Júnior
Rafaela de L.P. Sanchez-Lermen
Karina de A. Vieira
Renata V. de Oliveira
Francisco J.D. Souto, M.D., Ph.D.
Detection of hepatitis B activity in HBeAg-negative carriers with normal aminotransferase levels in central Brazil
Annals of Hepatology
Alanine aminotransferase
Aspartate aminotransferase
Cirrhosis
Inactive carrier
HBV
Cohort
title Detection of hepatitis B activity in HBeAg-negative carriers with normal aminotransferase levels in central Brazil
title_full Detection of hepatitis B activity in HBeAg-negative carriers with normal aminotransferase levels in central Brazil
title_fullStr Detection of hepatitis B activity in HBeAg-negative carriers with normal aminotransferase levels in central Brazil
title_full_unstemmed Detection of hepatitis B activity in HBeAg-negative carriers with normal aminotransferase levels in central Brazil
title_short Detection of hepatitis B activity in HBeAg-negative carriers with normal aminotransferase levels in central Brazil
title_sort detection of hepatitis b activity in hbeag negative carriers with normal aminotransferase levels in central brazil
topic Alanine aminotransferase
Aspartate aminotransferase
Cirrhosis
Inactive carrier
HBV
Cohort
url http://www.sciencedirect.com/science/article/pii/S1665268119311688
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