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- Title
The HBV DNA cutoff value for discriminating patients with HBeAg-negative chronic hepatitis B from inactive carriers.
- Authors
Eun Sun Kim; Yeon Seok Seo; Keum, Bora; Ji Hoon Kim; Hyonggin An; Hyung Joon Yim; Yong Sik Kim; Yoon Tae Jeen; Hong Sik Lee; Hoon Jai Chun; Soon Ho Um; Chang Duck Kim; Ho Sang Ryu
- Abstract
Background: Patients with HBeAg-negative chronic hepatitis B (CHB) has a significantly different prognosis than inactive carriers; there is however, no reliable strategy for accurately differentiating these two disease conditions. Objectives: To determine a strategy for discriminating patients with HBeAg-negative CHB from inactive carriers. Materials and Methods: Consecutive inactive carriers (i.e. HBeAg-negativity, anti-HBepositivity, normal ALT levels, and HBV DNA < 2000 IU/mL) were enrolled. HBV reactivation was defined as the elevation of the HBV DNA level to ? 2000 IU/mL. Patients were classified into true inactive carriers when their HBV DNA levels remained at < 2000 IU/mL or false inactive carriers when their HBV DNA levels increased to ? 2000 IU/mL during the first year. Results: The Mean ± SD age of 208 inactive carriers (140 males) was 47.7 ± 12.6 years. The Mean ± SD serum ALT and HBV DNA levels were 22.8 ± 8.6 IU/L and 360 ± 482 IU/ mL, respectively. HBV reactivation developed in 41 (19.7%) patients during the first year. Baseline HBV DNA and ALT levels differed significantly between true inactive and false inactive carriers. The AUROCs of the baseline ALT and HBV DNA levels for predicting a false inactive carrier were 0.609 and 0.831, respectively. HBV reactivation developed more often in patients with a baseline HBV DNA level of ? 200 IU/mL than in those with a baseline HBV DNA level of < 200 IU/mL during a Mean ± SD follow-up of 622 ± 199 days. Conclusions: The HBV DNA level was useful for discriminating patients with HBeAgnegative CHB from true inactive carriers. The follow-up strategies applied to inactive carriers need to vary with their HBV DNA levels.
- Subjects
CHRONIC diseases; HEPATITIS B; DISEASE relapse; CARRIER state (Communicable diseases); DIFFERENTIAL diagnosis; DIAGNOSTIC errors; DNA; MULTIVARIATE analysis; REGRESSION analysis; RESEARCH funding; STATISTICS; SURVIVAL analysis (Biometry); U-statistics; ALANINE aminotransferase; SEROCONVERSION; RECEIVER operating characteristic curves; DISEASE progression; PROGNOSIS
- Publication
Hepatitis Monthly, 2011, Vol 11, Issue 5, p351
- ISSN
1735-143X
- Publication type
Article