Stage of disease in hepatitis B virus infection in Zambian adults is associated with large cell change but not well defined using classic biomarkers.

Autor:	Nsokolo B; TROPGAN, Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia., Kanunga A; TROPGAN, Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia., Sinkala E; TROPGAN, Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia., Zyambo K; TROPGAN, Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia., Kumwenda D; Zambia National Blood Transfusion Service, University Teaching Hospital, Lusaka, Zambia., Chama D; Zambia National Blood Transfusion Service, University Teaching Hospital, Lusaka, Zambia., Muyinda G; Zambia National Blood Transfusion Service, University Teaching Hospital, Lusaka, Zambia., Vinikoor M; University of Alabama at Birmingham, Birmingham, Alabama, USA., Ijaz S; Blood-Borne Virus Unit, Microbiology Services, Public Health England, Colindale, UK., Tedder R; Blood-Borne Virus Unit, Microbiology Services, Public Health England, Colindale, UK., Elmdaah AKA; Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK., Jones M; Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK., Chiluba C; TROPGAN, Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia., Mudenda V; Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia., Goldin RD; Department of Hepatology, Imperial College London, London, UK., Foster G; Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK., Kelly P; TROPGAN, Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.; Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Jazyk:	angličtina
Zdroj:	Transactions of the Royal Society of Tropical Medicine and Hygiene [Trans R Soc Trop Med Hyg] 2017 Sep 01; Vol. 111 (9), pp. 425-432.
DOI:	10.1093/trstmh/trx077
Abstrakt:	Background: Hepatocellular malignancy in young adults is a prominent feature of hepatitis B virus (HBV) infection in southern Africa. Here we report a cross-sectional study of liver pathology correlated with biomarkers in adults with HBV infection in Zambia. Methods: We analysed liver biopsies from Zambian patients with persistent HBV infection. Results: We analysed 104 patients with HBV infection and evidence of liver disease. We obtained liver biopsies from 53 adults; of these, 12 (23%) were hepatitis B e antigen seropositive. The genotype was evenly distributed between A and E. One biopsy showed malignancy. Stage was 3 or more in 11 of 52 (21%) biopsies free of malignancy and lobular inflammation was found in 50 (94%). Neither alanine aminotransferase (ALT) nor the γ-glutamyl transferase:platelet ratio (GPR) were correlated with the stage of disease but were correlated with total Ishak score (ρ=0.47, p=0.0004 and ρ=0.33, p=0.02, respectively). Large cell change was observed in 10 of 11 biopsies with fibrosis stage 3 or more and 16 of 41 with early disease (p=0.005). Serum α-fetoprotein was elevated, although still within the normal range, in patients with large cell change (median 3.6 [interquartile range {IQR} 1.6-5.1]) compared with those without (1.7 [IQR 1.0-2.8]; p=0.03). Neither ALT nor GPR predicted large cell change. Conclusions: Large cell change was common in young HBV-infected adults in Zambia. Only serum α-fetoprotein was identified as a biomarker of this phenotype. (© The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu