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Natural seroconversion from hepatitis be antigen to antibody among hepatitis B virus carriers in Okinawa islands

In the Okinawa Islands, the great majority of hepatitis B surface antigen (HBsAg) carriers have already acquired antibody to hepatitis Be antigen (anti‐HBe) by the age of 30 years (preliminary cross‐sectional data). To elucidate natural seroconversion from hepatitis Be antigen (HBeAg) to anti‐HBe among HBsAg carriers found in the islands of Okinawa Prefecture, 34 HBeAg‐positive HBsAg carriers were followed for 1–6 years with serial measurements of aminotransferase levels, HBeAg, and anti‐HBe. The 34 subjects included 24 patients with chronic hepatitis (group 1) and ten asymptomatic HBsAg carriers (group 2). During the follow‐up period, HBeAg disappeared from 14 subjects in group 1 with the cumulative clearance rate of HBeAg of 56.3% within the first 2 years and with 10 of the 14 subsequently developing anti‐HBe. Moreover, the aminotransferases in 12 of the 14 spontaneously seroconverted fell into the normal range. The annual clearance rates of HBeAg among group 1 and group 2 were 25.6% and 9.3%, respectively. The tendency for early disappearance of HBeAg during a carrier's life time or in the course of chronic hepatitis may lead to the low death rate from hepatocellular carcinoma (HCC) particularly HCC associated with hepatitis B virus infection in this area.