Predictive value of FibroScan in detecting liver fibrosis in HBeAg negative patients with chronic hepatitis B whose HBV DNA 2000-20000 IU/ml with ALT 1-2 times the upper limit of normal and those with HBV DNA >20000 IU/ml and normal ALT

Both consensus and controversy remains regarding surrogacy of hepatitis B virus (HBV) deoxyribonucleic acid (DNA) and alanine aminotransferase (ALT), however, these markers are used to ascertain the extent of liver damages and to guide therapeutic options in patients with chronic hepatitis B. However, little is known about liver histology of patients with chronic hepatitis B with undetectable HBV DNA and persistently normal ALT. Thirty-five incidentally-detected patients with chronic HBV infection (assessed by expression of hepatitis B surface antigen for more than 6 months) with undetectable HBV DNA and normal serum ALT were enrolled in this study. Liver biopsy specimens were taken from all patients and the extent of hepatic necroinflammation and liver fibrosis were evaluated. Moderate degree of hepatic necroinflammation was detected in 2 of 35 patients and severe hepatic fibrosis was seen in 6 of 35 patients. Two patients with undetectable HBV DNA and sustained normal ALT had moderate hepatic necroinflammation and severe hepatic fibrosis. In spite of undetectable HBV DNA for prolonged period and persistently normal ALT, some patients with chronic hepatitis B express evidences of progressive liver diseases. Large scale studies in different races and geographical regions should be accomplished to develop insights about management of these patients. Studies about extent of liver diseases in these patients should be accomplished in Treatment recommendation and management strategies should be developed for these patients.Bangladesh Med Res Counc Bull 2014; 40 (3): 92-96

Download Full-text

Presence of Liver Inflammation in Asian Patients With Chronic Hepatitis B With Normal ALT and Detectable HBV DNA in Absence of Liver Fibrosis

Hepatology Communications ◽

10.1002/hep4.1859 ◽

2021 ◽

Author(s):

Jiacheng Liu ◽

Jian Wang ◽

Xiaomin Yan ◽

Ruifei Xue ◽

Jie Zhan ◽

...

Keyword(s):

Chronic Hepatitis ◽

Liver Fibrosis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Hbv Dna ◽

Liver Inflammation ◽

Asian Patients ◽

Normal Alt

Download Full-text

The Role of Liver Fibrosis Assessment in the Management of Patients with Chronic Hepatitis B Infection: Lessons Learned from a Single Centre Experience

Hepatitis Research and Treatment ◽

10.1155/2011/524027 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Raza Malik ◽

Patrick Kennedy ◽

Deepak Suri ◽

Ashley Brown ◽

Rob Goldin ◽

...

Keyword(s):

Chronic Hepatitis ◽

Liver Fibrosis ◽

Hepatitis B ◽

Liver Biopsy ◽

Chronic Hepatitis B ◽

Hbv Dna ◽

Hepatitis B Infection ◽

Chronic Hepatitis B Infection ◽

Normal Alt ◽

Severe Fibrosis

Background & Aims. Assess the clinical utility of the Prati criteria and normal ALT (<40 IU/L) in a cohort of patients with chronic hepatitis B infection (CHB). Methods. Serology, radiology, and histology were obtained in 140 patients with CHB. Results. HBeAg+ group: 7 patients (7/56−12% HBeAg+ group) misclassified as “immunotolerant”, with HBV DNA > 6 log copies/ml and normal ALT, who in fact had moderate/severe fibrosis on liver biopsy. HBeAg− group: 10 patients with normal ALT and moderate/severe fibrosis on liver biopsy; 4 of these patients had >3 log copies/ml HBV DNA levels and 6 patients misclassified as “inactive carriers” with negative HBV DNA levels normal ALT and moderate/severe fibrosis (6/84−7% HBeAg− group). Two male HBeAg+ and three male HBeAg- patients with ALT between 20 and 30 IU/L and moderate/severe fibrosis on liver biopsy would have been further mischaracterised using the Prati criteria for normal ALT. Age and ethnic group were more important predictors of moderate/severe fibrosis in multivariate analysis. Conclusion. HBeAg status, age, ethnic origin with longitudinal assessment of LFTs and viral load should be studied in patients with “normal ALT” at the upper end of normal range (ALT 20–40 IU/L) to appropriately classify patients and identify patients for liver fibrosis assessment to inform treatment decisions.

Download Full-text

Predictive Value of Hepatitis B Surface Antigen and Gamma-Glutamyl Transpeptidase for Significant Liver Fibrosis Among Patients with Immune-Tolerant Phase Chronic Hepatitis B

SSRN Electronic Journal ◽

10.2139/ssrn.3351986 ◽

2019 ◽

Author(s):

Yu-Rui Liu ◽

Jie-Min Zhang ◽

Zu-Xiong Huang ◽

Meng-Xin Lin ◽

Na-Ling Kang ◽

...

Keyword(s):

Chronic Hepatitis ◽

Liver Fibrosis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Predictive Value ◽

Hepatitis B Surface Antigen ◽

Gamma Glutamyl Transpeptidase ◽

Immune Tolerant ◽

Glutamyl Transpeptidase ◽

Significant Liver Fibrosis

Download Full-text

Total Antioxidant Capacity in HBV Carriers, a Promising Biomarker for Evaluating Hepatic Fibrosis: A Pilot Study

Antioxidants ◽

10.3390/antiox10010077 ◽

2021 ◽

Vol 10 (1) ◽

pp. 77

Author(s):

Jing-Hua Wang ◽

Sung-Bae Lee ◽

Dong-Soo Lee ◽

Chang-Gue Son

Keyword(s):

Oxidative Stress ◽

Chronic Hepatitis ◽

Liver Fibrosis ◽

Hepatitis B ◽

Antioxidant Capacity ◽

Chronic Hepatitis B ◽

Hepatic Fibrosis ◽

Total Antioxidant Capacity ◽

Hbv Dna ◽

Total Antioxidant

Oxidative stress plays a pivotal role in the progression of chronic hepatitis B; however, it is unclear whether the status of blood oxidative stress and antioxidant components differs depending on the degree of hepatic fibrosis. To explore the relationship between oxidative stress/antioxidant capacity and the extent of hepatic fibrosis, fifty-four subjects with liver fibrosis (5.5 ≤ liver stiffness measurement (LSM) score ≤ 16.0 kPa) by chronic hepatitis B virus (HBV) were analyzed. From the analysis of eight kinds of serum oxidative stress/antioxidant profiles and liver fibrosis degrees, the level of total antioxidant capacity (TAC) reflected a negative correlation with the severity of hepatic fibrosis (Pearson correlation, r = −0.35, p = 0.01). Moreover, TAC showed higher sensitivity (73.91%) than the aspartate transaminase (AST) to platelet ratio index (APRI, 56.52%) in the receiver operating characteristic (ROC) curves. Interestingly, the TAC level finely reflected the fibrosis degree in inactive carriers (HBV DNA < 2000 IU/mL), while the APRI did in active carriers (HBV DNA > 2000 IU/mL). In conclusion, TAC is a promising biomarker for evaluating the progression of liver fibrosis in patients with HBV, and this finding may indicate the involvement of TAC-composing factors in the pathogenesis of hepatic fibrosis in chronic HBV carriers.

Download Full-text