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What is the definition of inactive carrier?
Jul 21, 2005

Hello Dr. McGovern, Thank you for answering my question. You said not call my status inactive. But According to AASLD the difinition of inactive carrier is someone who has normal liver enzymes, HBeAg(-) anti HBe(+) and hbv DNA less than 10(4) (less than 10000) copies per/ml (PCR technique). I have always been in this category since I found out that I'm HBsAg(+) and my doctor told me I was inactive carrier. Don't everyone who has been previously infacted with the virus either acute or chronic will have some levels of the virus on their system. I've been readin pub med and there are articles that say even people who are HBsAg negative and HBsAb positive have some levels of the HBV DNA(between 10-200 copies/ml) in their blood. I some times read posting on this site from who people are worried when their HBV DNA is a few hundred or few thousand. they think that 105 is the level their hbv dna levels should be in order to be inactive. this is not 105 it is 10(5) or 100,000 copies/ml. Please answer this. thank you.

Response from Dr. McGovern

I am not sure if I understand your question, but let me try to be more clear.

Chronic hepatitis B is divided into "active" and "inactive" disease. All of these patients have hepatitis B surface antigen.

An inactive carrier has been hepatitis B surface antigen for > six months, is HBeAg negative, anti-HBe postive, has normal liver function tests, has HBV DNA levels less than 10(5) or less than 100,000 copies/ml.

However, as you correctly point out, hepatitis B can be "occult" and virus can be present in blood at low levels even in patients whom we do not consider as chronic carriers. However, the significance of this finding is unknown. As our assays for hepatitis B get better and better, we will find more people with low levels of viremia.

The other cautionery note is that patients are sometimes monitored with different testing assays, so some patients may have testing in copies per ml and others with picograms per ml. Both tests in the same person will give two different results.

Dr. McGovern



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