Association of anti‐HBc and liver inflammation in HBeAg‐negative chronic hepatitis B virus infected patients with normal ALT and detectable HBV DNA

Author(s):  
Kefang Yao ◽  
Jian Wang ◽  
Lijuan Wang ◽  
Juan Xia ◽  
Xiaomin Yan ◽  
...  
2016 ◽  
Vol 10 (1) ◽  
pp. 3-8
Author(s):  
ASM Salimullah ◽  
ASMA Raihan ◽  
MM Shahin Ul Islam ◽  
Mohammad Asadur Rahman ◽  
Dewan Saifuddin Ahmed ◽  
...  

Hepatitis B Virus (HBV) infection can causes spectrum of diseases ranging from clinically asymptomatic state to the development of cirrhosis and hepatocellular carcinoma (HCC). There is ongoing debate in the management of asymptomatic patients with chronic hepatitis B virus (CHBV) infection with high DNA and normal ALT level. It has been recently shown that a significant proportion of patients with CHBV infection with high DNA and normal ALT level have significant histological abnormality. So this study was aimed to see the histological changes in patients with CHBV infection with high DNA and ALT level <2 times of upper limit of normal (ULN). Total 64 patients were included in this cross sectional study. Mean age was 29 years, 55 (85.9%) patients were men. Forty patients (62.5%) were HBeAg positive. Thirty seven (57.8%) patients had normal ALT levels and 27 patients (42.2%) had ALT levels 1-2 x ULN. Out of 64 patients 46.8% had significant histological abnormalities. Among them 31.2% had significant fibrosis and 26.5% had significant necroinflammatory changes. Among 37 patients with normal ALT levels 35% had significant histological abnormalities. But among 27 patients with ALT levels of 1-2 x ULN, 63% had significant histological abnormalities. In this series significant histological abnormalities were found in 40% of HBeAg+ve cases and 58.3% of HBeAg-ve cases. But this difference was not statistically significant. It was also found that patients with significant histological abnormalities were significantly older and had a lower median HBV DNA level, lower mean platelet count, lower mean prothrombin activity ratio and lower mean albumin level than patients with nonsignificant histological changes. In logistic regression analysis it was found that serum ALT levels and age at which patients entered the study were independently associated with the risk for significant histological abnormalities.Faridpur Med. Coll. J. Jan 2015;10(1): 3-8


2013 ◽  
Vol 57 (7) ◽  
pp. 3369-3374 ◽  
Author(s):  
Young-Suk Lim ◽  
Ji-Young Lee ◽  
Danbi Lee ◽  
Ju Hyun Shim ◽  
Han Chu Lee ◽  
...  

ABSTRACTA 1-year trial with entecavir plus adefovir resulted in a rate of virological response (VR) higher than that seen with lamivudine plus adefovir in multiple-drug-refractory chronic hepatitis B (CHB) patients. This extension study enrolled 89 of 90 patients who completed a 52-week randomized trial comparing treatment with entecavir plus adefovir (EA) to treatment with lamivudine plus adefovir (LA). At the baseline of the original study, all patients had lamivudine-resistant hepatitis B virus (HBV) and serum HBV DNA > 2,000 IU/ml despite prior lamivudine plus adefovir therapy. Of the 89 enrolled patients, 45 initially randomized to receive entecavir plus adefovir and the other 44 randomized to receive lamivudine plus adefovir received entecavir plus adefovir for an additional 52 weeks (EA-EA and LA-EA, respectively). The proportions of patients with a VR (serum HBV DNA < 60 IU/ml) gradually increased in both groups and were comparable at week 104 (42.2% in the EA-EA group and 34.1% in the LA-EA group;P= 0.51). The mean reductions in serum HBV DNA from baseline in the two groups were similar (−2.8 log10IU/ml and −2.8 log10IU/ml, respectively;P= 0.87). At week 104, the number of patients who retained the preexisting HBV mutants resistant to adefovir or entecavir had decreased from 8 to 2 in the EA-EA group and from 15 to 6 in the LA-EA group (P= 0.27). Both study groups had favorable safety profiles. In conclusion, up to 104 weeks of entecavir plus adefovir treatment was associated with a progressive VR, a decrease of levels of preexisting drug-resistant mutants, and no selection for additional resistance mutants of HBV in multiple-drug-refractory CHB patients. (This study has been registered at ClinicalTrials.gov under registration no. NCT01023217.)


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