Evaluation of serum HBV viral load, transaminases and histological features in chronic HBeAg-negative hepatitis B patients
Gastroenterology and Hepatology from Bed to Bench,
Vol. 10 No. 1 (2017),
11 Bahman 2017
Introduction: Chronic hepatitis B infection (CHB) is a major global health problem. Hepatitis B e antigen (HBeAg)-negative is a common type of CHB in Iran. Liver damage in HBeAg-negative CHB leads to progressive form of the liver disease with poor prognosis. Therefore, it seems necessary to perform a comprehensive evaluation of different spectrum of laboratory measurements accompanying histological findings. The aim of this study was to evaluate the association between the biochemical, virologic and histologic features in HBeAg-negative CHB. Furthermore, we assessed the application of new cut-off values for alanine aminotransferase in HBeAg-negative CHB patients.
Materials and methods: HBeAg- negative CHB patients referring to hepatology clinics at Ghaem and Imam Reza hospitals during two years period were enrolled. Patients with alcohol consumption, liver mass, fatty liver and whom with positive results of Anti HDV, Anti HCV or Anti HIV were excluded. Liver enzymes were requested and Hepatitis B viral loads were measured by real time polymerase chain reaction (RT-PCR) in all patients. Liver biopsies were assessed by two expert pathologists. The relationship between viral loads, liver enzymes and histopathological features was analyzed using descriptive and analytic statistical methods.
Results: One hundred and fifty HBeAg-negative and HBe Ab-positive CHB patients (males=110, mean age=38.44±11.34 years) were assessed. Serum ALT levels had a significant relation with the logarithm of serum HBV-DNA levels (P<0.0001), grade and stage on liver biopsy (P<0.001, P=0.034, respectively). Serum viral load, AST and ALT levels were independent predictors of histological grade, but age was the only independent predictor of the stage of liver fibrosis. There was a significant relationship between serum ALT levels and stage of liver fibrosis (P<0.0001) when the new cutoff values for ALT were taken into account.
We also found that age had a significant relation with histological grade but it showed a reverse relation with alanine aminotransferase (ALT) levels (P=0.009).
Conclusions: In HBeAg-negative CHB patients, serum AST levels had a better predicting value for liver necrosis and inflammation. Moreover, age could be regarded as an independent predictor of the stage of liver fibrosis. This study revealed that the new cutoff values for ALT had superiority over the conventional values to identify patients with a higher risk of liver fibrosis.
Keywords: Hepatitis B, HBeAg, grade, stage, viral load, AST, ALT
- Hepatitis B
- viral load
How to Cite
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