No Such Thing as a Healthy Carrier

Recent advances in our understanding of hepatitis B has completely changed the advice given to people diagnosed with chronic (long term) hepatitis B.

Until recently a large number of people with chronic hepatitis B were thought to be “healthy carriers” and therefore not at risk of developing liver disease.  It is now known that it is not possible to predict whether someone will go on to develop liver problems and that all people with chronic hepatitis B should have regular long-term follow-up.  The good news is that ongoing monitoring allows for timely anti-viral treatment which is leading to better health outcomes.

What is now clear is that the level of the virus changes over time and that the immune system’s response to these changes influences the amount of liver damage. It is now understoon that there are four main phases of chronic hepatitis B.

The best way to identify when someone with chronic hepatitis B is moving from one phase to another is through regular ongoing follow-up.  If they are moving into a phase that is potentially more harmful to the liver they can be offered treatment to reduce or even reverse liver damage, and reduce the risk of other serious outcomes such as liver failure and liver cancer.

The term “healthy carrier” is a thing of the past.  All people with chronic hepatitis B should be encouraged to have regular, long-term follow-up.

For more information see understanding chronic hepatitis B natural history.