LONG-TERM FOLLOW-UP OF HEPATITIS-B VIRUS CARRIER INFANTS

One hundred twenty-two hepatitis B surface antigen (HBsAg) carrier inf ants were followed-up for 8-10 years. One hundred eleven had antibody to hepatitis B core antigen (anti-HBc; 83 had been vaccinated) and the remaining 11 were without anti-HBc (7 had been vaccinated). During th e follow-up period, 29 (26.1%) carrier infants with anti-HBc had one o r more episodes of alanine aminotransferase (ALT) elevation and up to 32.8% (21/64) of the carriers in this group lost their hepatitis B e a ntigen (HBeAg) before the age of 10. In addition, 2 (1.8%) carriers lo st their HBsAg at the age of 3 and 8, respectively. No significant sym ptom or sign was noted during HBeAg seroconversion. In contrast, all t he carrier infants without anti-HBc were still positive for both HBeAg and hepatitis 8 virus (HBV) DNA and none displayed abnormal ALT level s or any symptom related to liver disease. One became anti-HBc positiv e at the age of 9, and 5 other carriers had inconsistent borderline or weakly positive titers of anti-HBc. The episodes of ALT elevation and the prevalence of HBeAg seroconversion were not significantly differe nt between immunized carrier infants. In conclusion, HBeAg seroconvers ion may occur in about one third of the anti-HBc-positive carrier infa nts during the first decade. On the other hand, the anti-HBc-negative HBsAg carrier infants' immune incompetence to the HBV antigens could p ersist for more than 10 years. Hepatitis B immunization did not have s ignificant effect on the clinical course in carriers. (C) 1994 Wiley-L iss, Inc.