Incidences of HBeAg and anti-HBe in, and clinical course of hepatitis B virus carriers.

: A total of 336 hepatitis B virus (HBV) carriers were followed for more than 3 years with serial measurements of serological markers of HBV to determine the correlation between their clinical course and the HBeAg-anti-HBe system. In all, 139 had hepatitis B e antigen (HBeAg) at the beginning of the study. During the study, 30 of 139 HBeAg-positive carriers became HBeAg negative and subsequently gave a positive reaction for antibody to HBeAg (anti-HBe). The rate of seroconversion was 3.6% per year. Two types of profile of seroconversion were observed, rapid and gradual. No significant differences were observed in the incidences of HBeAg and anti-HBe in HBV carriers with or without liver cirrhosis (LC) and hepatocellular carcinoma (HCC). These findings do not support the report by Chung et al. (1983, J. Med. Virol. 11: 99-104) that a prolonged replicative phase of chronic HBV infection is essential for the occurrence of HCC. Two HBV carriers were diagnosed as having HCC at the time of seroconversion from HBeAg to anti-HBe. This finding supports the reports by Coursaget et al. (1978, J. Clin. Microbiol. 7: 394-395) and Musca et al. (1983, Hepatogastroenterology 30: 3-5) that actively replicating HBV sometimes becomes defective during the course of malignant transformation.