Morbidity and mortality from chronic hepatitis B virus infection in family members of patients with malignant and nonmalignant hepatitis B virus–related chronic liver diseases

✍ Scribed by Dr. Anna S. F. Lok; Ching-Lung Lai; Hau-Tim Chung; Johnson Y. N. Lau; Elsie K. Y. Leung; Loretta S. K. Wong

• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 508 KB
• Volume: 13
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840130506

✦ Synopsis

Three-hundred forty-one HBsAg-positive family members of 152 patients with chronic hepatitis B virus infection (47 asymptomatic carriers, 59 with chronic hepatitis, 17 with cirrhosis and 29 with hepatocellular carcinoma) were prospectively studied to determine the morbidity and mortality from chronic hepatitis B virus infection in the family members of patients with malignant and nonmalignant hepatitis B virus-related chronic liver diseases. Most of the family members had no history of acute hepatitis, were asymptomatic and were unaware of their carrier status. However, 5.3% had stigmata of chronic liver disease, 6% had serum ALT levels that exceeded two times the upper limit of normal and 78% of those who had biopsies had chronic hepatitis with or without cirrhosis.

During a follow-up period of 12 to 90 mo (median = 39 mo), 3% had symptoms of chronic liver disease; 24% had transient, recurrent or persistent elevation in serum ALT levels, 1.4% had cirrhosis and 1% had hepatocellular carcinoma. Neither hepatocellular carcinoma in the index patient nor a previous history of hepatocellular carcinoma in the family was associated with an increase in the morbidity and mortality from chronic hepatitis B virus infection in the HBsAg-positive family members. (HEPATOLOGY 199 1; 13:834-837.)

Intrafamilial transmission of HBV infection has been well documented (1-9). The risk of chronicity is high when infection is acquired during infancy or early childhood (10-13). Infection during early life is usually subclinical, and most carriers remain asymptomatic and unaware of their carrier status even on reaching adult life. Some carriers may have chronic hepatitis during adulthood; some are only aware of their carrier status