Lower baseline ALT cut-off values and HBV DNA levels better differentiate HBeAg(-) chronic hepatitis B patients from inactive chronic carriers

Table 1 Baseline characteristics of 91 patients with chronic hepatitis B virus infection

Patient characteristics	HBeAg (+) Chronic hepatitis B n = 32	HBeAg(-) hepatitis B		1P
		Inactive carriers n = 19	HBeAg(-) chronic hepatitis n = 40
Gender (M/F)	23/9	17/2	30/10	0.001
Age	32 ± 11	39 ± 10	39 ± 10	0.010
BMI	24.9 ± 2.5	25.1 ± 2.6	25.9 ± 2.0	0.300
Histological grade	4.6 ± 1.9 (4-12)	ND	4.4 ± 1.2 (4-18)	0.500
Histological stage	1.3 ± 1.4 (0-6)	ND	1.1 ± 1.3 (0-6)	0.500
ALT (IU/L)	118 (16-190)	24 (16-30)	52 (20-116)	0.001
AST (IU/L)	71 (11-142)	26 (16-34)	38 (17-143)	0.001
HBV DNA (median, copies/mL)	1.9 × 1011	4150	2 × 105	0.001

Values are median, or mean ± SD.

¹Comparison between 3 groups. ND: Not done. Every 19 IU/mL of HBV DNA equals 100 copies/mL. ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; HBV: Hepatitis B virus.

Table 2 Validity of ALT, AST and serum HBV DNA levels for the differentiation of patients with HBeAg (-) chronic hepatitis B from inactive chronic HBsAg carriers

Laboratory test	SP %	SS %	PPV %	NPV %	Diagnostic accuracy %	Inactive carriers n = 19	HBeAg(-) hepatitis B n = 40
ALT (> vs ≤ 2 ULN)	100	33	100	41	54	0/19	27/13
ALT (> vs ≤ 1.3 ULN)	47	90	78	69	78	10/9	36/4
AST > ULN	84	45	86	42	58	3/16	22/18
HBV DNA (> vs < 50 000 copies/mL)	57	73	97	62	80	1/18	29/11
HBV DNA 50 000 + ALT > (1.3 ULN)	95	80	96	69	85	1/18	32/8

Every 19 IU/mL of HBV DNA equals 100 copies/mL. Upper normal limit (ULN) for ALT: 30 IU/L for men and 19 IU/L for women.

Table 3 Validity of HBV DNA levels for the differentiation of patients with HBeAg(-) chronic hepatitis B from inactive carriers and normal ALT values

HBV DNA levels (Copies/mL)	Specificity %	Sensitivity %	Predictive value %		Correct classification	Inactive carriers	HBeAg(-) hepatitis B
			PPV	NPV
HBV DNA > vs < 50 000	95	78	78	95	91	1/18	4/1
HBV DNA > vs < 100 000	95	78	78	95	91	1/18	4/1
HBV DNA > vs < 20 000	73	80	44	93	75	5/14	4/1
HBV DNA > vs < 5000	57	75	78	52	70	8/11	3/2

HBV DNA: Every 19 IU/mL equals 100 copies/mL.

Table 4 Validity of ALT (ULN 30/19) and baseline serum HBV DNA levels for the differentiation of patients with HBeAg(-) chronic hepatitis B from inactive carriers

Laboratory test	SP %	SS %	PPV %	NPV %	Diagnostic accuracy %	Inactive carriers n = 19	HBeAg(-) hepatitis B n = 40
ALT (> vs ≤ 30 M/19 F)	100	92	100	86	95	0/19	37/3
HBV DNA (> vs ≤ 100 000 copies/mL)	73	72	85	56	72	5/14	29/11
ALT+ HBV DNA	100	92	100	86	95	0/19	37/3