A certain number of people with hepatitis B become hepatitis B inactive carriers. This means they carry the hepatitis B virus, but they have normal liver enzymes and dont have signs of significant liver inflammation. Even though the hepatitis B is inactive, hepatitis B inactive carriers are still at higher risk for health problems since the virus can become reactivated in up to twenty-five percent of cases - which leads to active inflammation and even cirrhosis. This occurs most commonly in people with decreased immunity.
People with inactive hepatitis B are also at a higher risk of liver cancer. In a recent study that looked at over 20,000 people with inactive hepatitis B disease, the yearly risk of getting cancer of the liver was 0.06% or about six out of one thousand. The risk was higher in people who were older, those who drank alcohol, and those with higher baseline levels of a liver enzyme called ALT.
If you have chronic inactive hepatitis B, its important to get your liver enzymes checked every three to six months to monitor for signs of liver inflammation - which could indicate that the hepatitis B virus has become active. Interestingly, its not the virus itself that causes damage to the liver, but the immune response which causes inflammation and tissue damage. As long as theres no evidence that the virus is active, chronic inactive hepatitis B usually doesnt require treatment.
What about the higher risk of liver cancer with inactive hepatitis B? Theres no sure way to prevent it, but avoiding alcohol lowers the risk of developing cancer of the liver in people with inactive hepatitis B. The best action plan if youre a hepatitis B inactive carrier is to eliminate alcohol entirely from your diet and see your doctor at least every six months to monitor for signs of virus reactivation or liver inflammation. Dont assume because the virus is inactive, that youre no longer at risk for health problems.
References:
Family Practice News, May 1, 2010. page 42.
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