Cell death biomarker M65 is a useful indicator of liver inflammation and fibrosis in chronic hepatitis B

Background. It has been suggested that chronic hepatitis B infection leads to growth impairment, but data are inconsistent and underlying factors are not defined.Methods. Children and adolescents with chronic hepatitis B (HBV) or C (HCV) were retrospectively evaluated for growth, weight, antiviral treatment, biochemical signs of liver inflammation, route of infection, and HBV DNA, respectively.Results. In all, 135 children (mean age 6.1 years, 81 male, 54 female) with HBV (n=78) or HCV (n=57) were studied. Route of infection was vertical in 50%, parenteral in 11%, and unknown in 39%. ALT levels were above 1.5 times above normal in 30% while 70% had normal/near normal transaminases. 80% were Caucasian, 14% Asian, 1% black, and 4% unknown. Mean baseline height measured in SDS was significantly lower in the study population than in noninfected children (boys −1.2, girls −0.4,P<0.01). 28 children were below 2 standard deviations of the norm while 5 were above 2 standard deviations. SDS measures in relation to individual factors were as follows: elevated ALT: boys −1.4, females −0.5 (P<0.01), ALT normal/near normal: boys +0.4, females +0.6; parenteral transmission: boys −3.3, girls −0.9 (P<0.01), vertical transmission: boys −0.2, females −0.2. Antiviral treatment itself or HBV-DNA load did not reach statistically significant differences.Conclusions. Chronic HBV or HCV may lead to compromised growth which is mostly influenced by liver inflammation. Our data may argue for early antiviral treatment in children with significant ALT elevation.

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Role of activation-induced cell death in pathogenesis of patients with chronic hepatitis B

World Journal of Gastroenterology ◽

10.3748/wjg.v9.i10.2356 ◽

2003 ◽

Vol 9 (10) ◽

pp. 2356 ◽

Cited By ~ 4

Author(s):

Chun-Sheng Hou

Keyword(s):

Cell Death ◽

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Activation Induced Cell Death

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Diagnostic Efficacy of FibroScan for Liver Inflammation in Patients with Chronic Hepatitis B --- A Single-Center Study with 1,185 Liver Biopsies as Controls

10.21203/rs.3.rs-964639/v1 ◽

2021 ◽

Author(s):

Kaiping Jiang ◽

Lei Zhang ◽

Jianhong Li ◽

Hongtao Hu ◽

Qinghua Huang ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Liver Biopsy ◽

Chronic Hepatitis B ◽

Liver Stiffness ◽

Roc Curves ◽

Diagnostic Value ◽

Liver Inflammation ◽

Roc Curve Analysis ◽

Diagnostic Efficacy

Abstract Background: Noninvasive diagnostic technologies that can dynamically monitor changes in liver inflammation are highly important for the management of chronic hepatitis B (CHB) patients and thus warrant further exploration. This study assessed the diagnostic efficacy of FibroScan for liver inflammation in CHB patients.Methods: A total of 1185 patients were selected, and ultrasound-guided liver biopsy was performed within one month after the FibroScan test. The liver stiffness measurement (LSM), the reliability criteria (IQR/M) of LSM, the quality of liver biopsy (complete portal area, PA), and the liver inflammation grades were the main observation items of this study. With liver biopsy as the control, the diagnostic efficacy of FibroScan for liver inflammation in CHB patients was evaluated by receiver operating characteristic (ROC) curve analysis.Results: Significant differences in the LSM of FibroScan were observed among different grades of liver inflammation (P<0.0001). Liver biopsy (PA>10) served as the control, and the cutoff point and the area under ROC curves (AUCs) of the LSMs for different inflammation grades were as follows: G2, 8.6 kPa, 0.775; G3 9.8 kPa, 0.818; and G4, 11.0 kPa; 0.832. With LSM cutoff values of 8.6 kPa, 9.8 kPa and 11.0 kPa, FibroScan showed certain diagnostic value for CHB patients with G2, G3 and G4 liver inflammation, especially those with G4 inflammation. Conclusions: The results of this study preliminarily showed that, in addition to liver fibrosis, FibroScan could evaluate liver inflammation in CHB patients in a noninvasive manner.

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A Non-invasive Model for Predicting Liver Inflammation in Chronic Hepatitis B Patients With Normal Serum Alanine Aminotransferase Levels

Frontiers in Medicine ◽

10.3389/fmed.2021.688091 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiaoke Li ◽

Yufeng Xing ◽

Daqiao Zhou ◽

Huanming Xiao ◽

Zhenhua Zhou ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Liver Biopsy ◽

Chronic Hepatitis B ◽

Alanine Aminotransferase ◽

Liver Inflammation ◽

Timely Initiation ◽

Invasive Approach ◽

Non Invasive ◽

Normal Alt

Background and Aims: Chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) levels are at risk of disease progression. Currently, liver biopsy is suggested to identify this population. We aimed to establish a non-invasive diagnostic model to identify patients with significant liver inflammation.Method: A total of 504 CHB patients who had undergone liver biopsy with normal ALT levels were randomized into a training set (n = 310) and a validation set (n = 194). Independent variables were analyzed by stepwise logistic regression analysis. After the predictive model for diagnosing significant inflammation (Scheuer's system, G ≥ 2) was established, a nomogram was generated. Discrimination and calibration aspects of the model were measured using the area under the receiver operating characteristic curve (AUC) and assessment of a calibration curve. Clinical significance was evaluated by decision curve analysis (DCA).Result: The model was composed of 4 variables: aspartate aminotransferase (AST) levels, γ-glutamyl transpeptidase (GGT) levels, hepatitis B surface antigen (HBsAg) levels, and platelet (PLT) counts. Good discrimination and calibration of the model were observed in the training and validation sets (AUC = 0.87 and 0.86, respectively). The best cutoff point for the model was 0.12, where the specificity was 83.43%, the sensitivity was 77.42%, and the positive likelihood and negative likelihood ratios were 4.67 and 0.27, respectively. The model's predictive capability was superior to that of each single indicator.Conclusion: This study provides a non-invasive approach for predicting significant liver inflammation in CHB patients with normal ALT. Nomograms may help to identify target patients to allow timely initiation of antiviral treatment.

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