Clinical and histopathological features of chronic hepatitis B virus infected patients with high HBV-DNA viral load and normal alanine aminotransferase level: A multicentre-based study in China.

Autor: Xing YF; Department of Hepatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China., Zhou DQ; Department of Hepatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China., He JS; Department of Hepatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China., Wei CS; Department of Hepatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China., Zhong WC; Department of Hepatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China., Han ZY; Department of Hepatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China., Peng DT; Department of Hepatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China., Shao MM; Department of Pathology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China., Sham TT; Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China., Mok DK; Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China.; State Key Laboratory of Chinese Medicine and Molecular Pharmacology (Incubation), Shenzhen, China., Chan CO; Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China.; State Key Laboratory of Chinese Medicine and Molecular Pharmacology (Incubation), Shenzhen, China., Tong GD; Department of Hepatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2018 Sep 04; Vol. 13 (9), pp. e0203220. Date of Electronic Publication: 2018 Sep 04 (Print Publication: 2018).
DOI: 10.1371/journal.pone.0203220
Abstrakt: Background: The aim of this study is to reveal the clinical and histopathological features of HBsAg-positive and HBeAg-positive chronic hepatitis B infected patients with high level of HBV DNA, from 17 hospitals and medical centres in China, with alanine aminotransferase levels within the lower region of normal range versus those with levels within the upper region of normal range and to investigate the clinical risk factors for the requirement of treatment through the examination of liver biopsy.
Methods: Liver biopsy was performed on high level of HBV DNA of 455 patients with HBsAg-positive and HBeAg-positive chronic hepatitis B infection and persistently normal alanine aminotransferase level. Liver necroinflammation and fibrosis were graded per the Knodell histological activity index and Ishak's fibrosis score, respectively. Univariate analysis of the clinical parameters versus necroinflammation and fibrosis was carried out.
Results: Of the subjects in this multicentre-based study, 5.49% and 10.11% had significant necroinflammation with Knodell histological activity index ≥ 9 and hepatic fibrosis stages with Ishak scores ≥ 3, respectively. The subjects were stratified into three age groups (30-39, 40-49 and ≥ 50 years), and our data clearly suggested that age, particularly in the age group over 50, was an independent predictor of liver necroinflammation and fibrosis. Lower HBV-DNA viral levels were found in patients with Knodell histological activity index ≥ 9 or advanced fibrosis (Ishak scores ≥ 3).
Conclusion: Our results showed that histological changes in liver tissues were observed in a significant proportion of patients with persistently normal alanine aminotransferase level. According to the data evaluation results, liver biopsy is advisable for HBeAg-positive chronic hepatitis B infected patients aged older than 40 and high HBV-DNA viral load in China.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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