In an effort to determine the importance of hepatitis B antigenemia in apparently healthy blood donors, 12 asymptomatic male recruit trainees with hepatitis B antigenemia were studied by means of history and physical examination, biochemical tests of hepatic function, and percutaneous hepatic biopsy. All had normal physical examination results. Nine had normal liver function; three had increased enzymes. On biopsy, five had normal hepatic tissue; seven had changes consistent with viral hepatitis. No patient had persistent limiting plate disruption, cirrhosis, or hepatic steatosis.
A reasonable approach to apparently healthy hepatitis B antigen carriers may be to observe them clinically and with biochemical tests of hepatic function as long as no evidence of chronic liver disease appears and to reserve liver biopsy for those who have persistent hepatic inflammation. The long-term importance of hepatitis B antigenemia remains unclear.