Significant hepatic histopathology in chronic hepatitis B patients with serum ALT less than twice ULN and high HBV-DNA levels in Indonesia.

Autor: Lesmana CR; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia. medicaldr2001id@yahoo.com, Gani RA, Hasan I, Simadibrata M, Sulaiman AS, Pakasi LS, Budihusodo U, Krisnuhoni E, Lesmana LA
Jazyk: angličtina
Zdroj: Journal of digestive diseases [J Dig Dis] 2011 Dec; Vol. 12 (6), pp. 476-80.
DOI: 10.1111/j.1751-2980.2011.00540.x
Abstrakt: Objective: To study the prevalence of significant hepatic histopathology in chronic hepatitis B (CHB) patients with alanine aminotransferase (ALT) ≤ twice upper limit of normal (ULN) and its association with age, HBeAg status, hepatitis B virus (HBV)-DNA level and viral genotype.
Methods: A prospective study was conducted over a 3-year period in treatment-naive CHB patients with ALT ≤ twice ULN. Patients with a history of acute flare hepatitis, use of alcohol and hepatotoxic drugs, hepatitis C, hepatitis D and human immunodeficiency virus (HIV) co-infection were excluded from the study. Hepatic histopathology was assessed according to the METAVIR scoring system.
Results: A total of 145 patients were recruited, 81 (55.9%) of whom were male. The patients' mean age was 41.50 ± 10.74 years (range 16-70 years). Significant hepatic inflammation was found in 59.3% of these patients, and significant hepatic fibrosis was found in 62.1%, the latter being associated with hepatitis B e antigen status, ALT levels and serum HBV-DNA, but not with their age group or viral genotype. Significant hepatic fibrosis was found in 24 of 35 CHB patients (68.6%) who were previously considered in an immunotolerance phase.
Conclusions: The prevalence of significant hepatic histopathology in CHB patients with serum ALT levels ≤ twice ULN is high. Delayed antiviral treatment can be harmful.
(© 2011 The Authors. Journal of Digestive Diseases © 2011 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.)
Databáze: MEDLINE
Externí odkaz: