BACKGROUND: Osteopenia has been recognized as one of the potential complications of chronic liver disease. However, its correlation with hepatits B virus (HBV) carriage has not been reported. Thus this study was aimed to clarify the relationship between osteopenia and HBV carriage. METHODS: Bone density was measured in 192 HBV carrier women and 200 healthy women in the following sites: the lumbar spine and three sites of the proximal femur (the neck, Ward's triangle, greater trochanter) by dual-photon absorptiometry. Liver function tests (AST, ALT, Albumin, GGT, and ALP) were also performed. RESULTS: The levels of the bone density measured at the four sites were significantly correlated with each other (r=0.34 to 0.99, P<0.01). Compared with the control group, HBV carriers showed a significant decrease in the bone density of the femur (P<0.05); the decrease was particularly marked at the Ward's triangle. A negative correlation was found between bone density and serum total alkaline phosphatase level (r=-0.44, P<0.01). CONCLUSIONS: Osteopenia was more prevalent in HBV carriers, particularly in those younger than 50 years of age. Serum total alkaline phosphatase level was higher in those with a reduced bone density; thus, the measurement of bone density may be indicated in female HBV carriers.