The natural history of asymptomatic hepatitis B surface antigen carriers

Roberto De Franchis, Gianmichele Meucci, Maurizio Vecchi, Maria Tatarella, Massimo Colombo, Ersilio Del Ninno, Maria Grazia Rumi, Maria Francesca Donato, Guido Ronchi

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Abstract

Objective: To assess the long-term outcome in hepatitis B surface antigen (HBsAg) carriers who have normal liver function tests, focusing on survival and the development of severe liver disease and hepatocellular carcinoma. ■ Design: Cohort study with a mean follow-up of 130 months. ■ Setting: Liver clinic of a referral center. ■ Patients: Ninety-two HBsAg-positive blood donors with normal liver function tests. ■ Measurements: Histologic evaluation of liver specimens at baseline; clinical, biochemical, and serologic follow-up; and repeat liver biopsy if clinically indicated or after 10 years of follow-up. ■ Results: At baseline, 69 subjects had normal histologic findings or only minor abnormalities, 18 had chronic persistent hepatitis, and 5 had mild chronic active hepatitis. Serum enzyme levels remained normal in 58 of 68 patients who had regular follow-up. Three patients had biochemical changes consistent with hepatitis B virus (HBV) infection; in one of these patients, a later histologic evaluation showed progression to chronic active hepatitis. One patient developed alcoholic cirrhosis. Six other patients had mild or transient transaminase elevations, with no evidence of HBV replication, hepatitis D virus infection, hepatitis C virus (HCV) infection, or histologic deterioration. Liver histologic findings also remained unchanged in 21 patients who showed no biochemical changes during 10 years of follow-up and consented to have repeated liver biopsy. Ten patients showed loss of HBsAg; 2 of these patients acquired antibody to hepatitis B surface antigen (anti-HBs). All patients who did not have regular follow-up, except 1, were interviewed by telephone during 1990: All denied having liver disease. No patients developed hepatocellular carcinoma. ■ Conclusions: Italian HBsAg carriers with initially normal liver function tests have an excellent prognosis: Delta superinfection is infrequent and the risk for developing hepatocellular carcinoma is low.

Original languageEnglish
Pages (from-to)191-194
Number of pages4
JournalAnnals of Internal Medicine
Volume118
Issue number3
Publication statusPublished - Feb 1 1993

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Hepatitis B Surface Antigens
Natural History
Liver Function Tests
Virus Diseases
Chronic Hepatitis
Liver
Hepatocellular Carcinoma
Hepatitis B virus
Liver Diseases
Hepatitis D
Hepatitis Delta Virus
Biopsy
Alcoholic Liver Cirrhosis
Virus Replication
Transaminases
Blood Donors
Telephone
Hepacivirus
Cohort Studies
Referral and Consultation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

De Franchis, R., Meucci, G., Vecchi, M., Tatarella, M., Colombo, M., Del Ninno, E., ... Ronchi, G. (1993). The natural history of asymptomatic hepatitis B surface antigen carriers. Annals of Internal Medicine, 118(3), 191-194.

The natural history of asymptomatic hepatitis B surface antigen carriers. / De Franchis, Roberto; Meucci, Gianmichele; Vecchi, Maurizio; Tatarella, Maria; Colombo, Massimo; Del Ninno, Ersilio; Rumi, Maria Grazia; Donato, Maria Francesca; Ronchi, Guido.

In: Annals of Internal Medicine, Vol. 118, No. 3, 01.02.1993, p. 191-194.

Research output: Contribution to journalArticle

De Franchis, R, Meucci, G, Vecchi, M, Tatarella, M, Colombo, M, Del Ninno, E, Rumi, MG, Donato, MF & Ronchi, G 1993, 'The natural history of asymptomatic hepatitis B surface antigen carriers', Annals of Internal Medicine, vol. 118, no. 3, pp. 191-194.
De Franchis R, Meucci G, Vecchi M, Tatarella M, Colombo M, Del Ninno E et al. The natural history of asymptomatic hepatitis B surface antigen carriers. Annals of Internal Medicine. 1993 Feb 1;118(3):191-194.
De Franchis, Roberto ; Meucci, Gianmichele ; Vecchi, Maurizio ; Tatarella, Maria ; Colombo, Massimo ; Del Ninno, Ersilio ; Rumi, Maria Grazia ; Donato, Maria Francesca ; Ronchi, Guido. / The natural history of asymptomatic hepatitis B surface antigen carriers. In: Annals of Internal Medicine. 1993 ; Vol. 118, No. 3. pp. 191-194.
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