A STUDY TO DETERMINE FOLLOW-UP STRATEGY FOR DIFFERENTIATING A TRUE INACTIVE CARRIERS FROM CHRONIC HEPATITIS PATIENTS WITH HBEAG NEGATIVE BY THE HBV DNA CUTOFF VALUE

Abstract

Background & Objective: As compare to true inactive carrier a significantly different prognosis generally observed in Patients with HBeAg-negative chronic hepatitis B (CHB). To differentiate this two condition accurately there are no reliable strategy. To determine follow-up strategy for differentiating a true inactive carriers from chronic hepatitis patients with HBeAg negative by the HBV DNA cutoff value. Materials and Methods: We had enrolled potential inactive carriers who were consecutive untreated patients. This inactive carriers defined as HBV DNA < 2000 IU/mL, normal ALT levels, anti-HBe-positive and definitely HBeAg-negative. HBV DNA level to ≥ 2000 IU/mL was defined as the HBV reactivation. Patients whose HBV DNA levels remained at < 2000 IU/mL were classified as true inactive carriers and patients whose HBV DNA level to ≥ 2000 were classified as false inactive carriers during the first year. Results: Among 112 inactive carrier (age, 48.3 ± 13.1 years) who were initially selected, 75 were males. As identified, 23.2 ± 7.9 IU/L and 359 ± 478 IU/mL were serum ALT and HBV DNA levels, respectively. In 24 patients there were a significant drop in HBV reactivation during the first year. Between true and false inactive carriers there were a significantly different ALT and HBV DNA levels. In patients, whose baseline HBV DNA level was ≥ 200 IU/mL as compare to patients whose baseline HBV DNA level was < 200 IU/mL, HBV reactivation developed more often during a follow-up of 354 ± 175 days. Conclusion: From true inactive carriers to differentiate patients with HBeAg-negative CHB, HBV DNA level was useful tool. As per HBV DNA level of inactive carriers applied follow-up strategies need to vary.