PTU-107 Defining the low-risk inactive carrier in chronic hepatitis b with qhbsag: do the same rules apply in children and young adults?

Introduction A substantial proportion of e-Antigen negative chronic hepatitis B (CHB) under specialist follow-up are inactive carriers (IC) defined as those with low serum ALT and HBV DNA. Recent studies have described the potential utility of quantitative Hepatitis B surface antigen (qHBsAg) ( 1,000 IU/ml) are associated with an increase in risk of disease progression. 1 Accurate identification of low-risk IC’s would reduce the frequency of follow-up and the need for HCC screening in selected patients. We investigated whether a qHBsAg threshold ( Method Fifty-six consecutive treatment naive eAg negative young patients ( 30 years) based on the same parameters were included for comparison; female = 33%, median age = 42 years (range 31–61 years). HBsAg levels were quantified in all patients to determine any correlation between the qHBsAg threshold ( Results In keeping with an IC disease profile, serum ALT and HBV DNA levels in both cohorts were similar (p = ns), however, qHBsAg levels were significantly higher in the 30s; mean qHBsAg 10,545 IU/ml vs. 5,278 IU/ml (p = 0.006). In accordance with this we detected a significant negative correlation with age and qHBsAg (Spearman Rho rs = -0.35, p = 0.0004). A significantly higher proportion of older patients had qHBsAg Conclusion The addition of qHBsAg to serum ALT and HBV DNA can enhance risk stratification. However, a threshold level ( Disclosure of interest None Declared. Reference Tseng TC, Liu CJ, Yang HC, et al . High levels of hepatitis B surface antigen increase risk of hepatocellular carcinoma in patients with low HBV load. Gastroenterology 2012;142:1140–1149