Serum Hepatitis B Virus DNA Levels and Liver Histology in Inactive HBsAg Carriers

J Hepatol. 2002 Apr;36(4):543-6. doi: 10.1016/s0168-8278(02)00004-1.


Background/aims: A recent NIH research workshop on hepatitis B virus (HBV) revisited the definition of healthy HBsAg carriers. The new definition inactive surface antigen (HBsAg) carriers includes an estimated serum HBV DNA level below 105 copies/ml. However, this cut-off value needs to be confirmed.

Methods: Eighty-five consecutive patients, HBsAg-positive/HBeAg-negative with persistently normal alanine aminotransferase (ALT) and undetectable serum HBV DNA with standard assay (Versant HBV DNA Assay (bDNA), Bayer) were prospectively followed for 3.2+/-2.6 (range 0.5-11) years; 58 underwent a liver biopsy. Serum HBV DNA was quantified with a sensitive polymerase chain reaction assay (Cobas Amplicor HBV Monitor, Roche) (sensitivity 200 copies/ml), and liver histology was assessed using the Ishak scoring system.

Results: The median serum HBV DNA level was 1300 copies/ml (<200-179 x 10(3) copies/ml), 16% of the subjects had no detectable serum HBV DNA and 98% had levels below 10(5) copies/ml. Histologic lesions were mild (total score <7) in all cases. Loss of HBsAg was observed in three patients, three patients experienced a transient increase in ALT (<2 x upper limit of normal), and serum HBV DNA levels remained stable (1-6 years) in 97% of the 38 patients retested.

Conclusions: In our study of inactive HBsAg carriers, the median serum HBV DNA level was 1300 copies/ml, the serum HBV DNA level was below 10(5) copies/ml in 98% of the patients, and remained stable; histological lesions were mild in all cases.

MeSH terms

  • Adult
  • Carrier State / blood*
  • Carrier State / pathology*
  • DNA, Viral / blood*
  • Female
  • Follow-Up Studies
  • Gene Dosage
  • Hepatitis B Surface Antigens / analysis*
  • Hepatitis B virus / genetics*
  • Humans
  • Liver / pathology*
  • Male
  • Middle Aged
  • Polymerase Chain Reaction / methods


  • DNA, Viral
  • Hepatitis B Surface Antigens