The Prognosis of the Healthy HBsAg Carrier State

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Abstract
Thirty-six persons found to be healthy HBsAg carriers by routine donor screening from 1970 to 1973 were offered a follow-up examination in 1978. A total of 21 out of the 34 still living carriers were reexamined clinically, serologically, and biochemically. Seventeen of the 20 still HBsAg-positive carriers had anti-HBe, and 2 were HBeAg-positive. Liver biopsy in these two carriers showed chronic persistent hepatitis. No biochemical abnormalities were found in any but one who was HBeAg-positive and one who was negative for both HBeAg and anti-HBe. Anti-HBc titers varied between 1:3,600 and 1:83,000. Circulating immune complexes were demonstrated in 30% of the healthy HBsAg carriers. On the basis of 5-8 years' follow-up it is concluded that the healthy HBsAg carrier state is a benign condition that has not affected the carrier's quality of life. Progression to a severe, chronic liver disease was not observed in any of the healthy carriers. The importance and nature of circulating immune complexes in healthy HBsAg carriers are unknown and need further investigation.