[Clinico-morphological characteristics of chronic HbcAg-negative HBV infection with a normal level of aminotransferases]

To study clinicomorphological characteristics and a course of chronic HbeAg-negative HBV-infection with a normal level of aminotransferases, 38 patients whose blood contained HbsAg, HBVDNA and anti-Hbe were divided into 2 groups: with normal (20 patients, test group) and elevated (18 patients, control group) level is of aminotransferases. All the patients' livers were studied morphologically and semiquantitative test for viremia was made. Compared to the controls, the test group patients had low morphological activity (3.4 +/- 1.1 and 8.7 +/- 3.2, respectively, p0.005), a fibrosis degree (1.1 +/- 0.4 and 2.3 +/- 1.4 score, respectively p0.01) and viremia (log 10 - 3.7 +/- 1.2 vs 6.1 +/- 2.4, p0.05). The monofactor analysis has established that viremia 10(5) cop/ml maximum significantly associates with a normal level of aminotransferases (chi-square = 7.89, p = 0.005) while viremia higher than 10(7) cop/ml strongly correlates with a high level of aminotransferases (chi-square = 4.11, p = 0.043). Follow-up of patients with a normal level of aminotransferases for 28 +/- 24 months (6-72 months) showed neither deterioration of the clinical status nor laboratory changes. Thus, patients having anti-HBe and no HbeAg with a normal level of ALT and low viremia (under 10(5) cop/ml) can be considered inactive carriers of HbsAg. In spite of a relatively favourable prognosis, these patients should be followed up for a long time.