Premium
Long‐term follow‐up study of asymptomatic hbsag‐positive voluntary blood donors in austria: A clinical and histologic evaluation of 242 cases
Author(s) -
Dragosics Brigitte,
Ferenci Peter,
Hitchman Eva,
Denk Helmut
Publication year - 1987
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840070215
Subject(s) - medicine , hbsag , hepatocellular carcinoma , asymptomatic , cirrhosis , hbeag , gastroenterology , asymptomatic carrier , liver biopsy , hepatitis , subclinical infection , liver disease , hepatitis b , biopsy , pathology , immunology , hepatitis b virus , virus
Two hundred forty‐two voluntary blood donors, referred after detection of HBsAg positivity, underwent clinical evaluation and liver biopsy and were prospectively followed for an average of 3.5 years. At initial testing, 65% of HBsAg carriers had normal laboratory findings; during follow‐up, 26% of these carriers developed abnormal test results, at least transiently. Liver histology was normal in 31.4%, revealed nonaggressive liver disease in 63.6% and chronic active hepatitis or cirrhosis in 5%, only. All except one case of chronic active hepatitis or cirrhosis were associated with abnormal blood biochemical tests. Sequential liver biopsies obtained in 56 HBsAg carriers after a minimal interval of 4 years showed mitigation of inflammatory changes in 5.4% and developing chronic active hepatitis in three cases (5.4%). One carrier died of primary hepatocellular carcinoma. Upon follow‐up, HBsAg persisted in 98%. Anti‐HBe was found in 90% of all carriers already at the initial testing. HBeAg positivity (7.5%) was associated with chronic active hepatitis as well as nonaggressive liver disease; clearance of HBeAg occurred in 40% after 2 to 8 years. Because of the subclinical progression of liver disease and the increased risk for developing primary hepatocellular carcinoma in asymptomatic HBsAg carriers, routine blood testing, including α‐fetoprotein screening, as well as abdominal ultrasound surveillance are indicated. Liver biopsy, however, should be restricted to carriers with abnormal biochemical findings.