scholarly journals Liver Histological Abnormalities Were Better Reflected by Virus Level in Chronic Hbv Infected Patients Aged ≤ 30 Years, Hbeag-Positive and Persistently Normal Alt

2021 ◽  
Author(s):  
Li Wei ◽  
Xiaoqing Liu ◽  
Qiao Tang ◽  
Hu Li ◽  
Peng Hu
Keyword(s):  
Threshold Value ◽  
Hbv Dna ◽  
Roc Curve Analysis ◽  
Pathological Alteration ◽  
Virus Level ◽  
Histological Abnormality ◽  
Histological Characteristics ◽  
Chronic Hbv ◽  
Normal Alt ◽  
Almost All

Abstract Background: We analyzed correlations between significant liver histological characteristics and clinical variables in HBV-infected patients and provided recommendations on treatment decisions for patients age younger than 30-year-old.Methods: Liver biopsy was performed on 161 chronic HBV-infected patients with ALT ≤ 40 U/L from July, 2000 – November, 2019. Median age was 39(18-70) years old. Histologic assessment was based on the Scheuer scoring system. Results: Significant necroinflammation and fibrosis were observed in 65.2% (105/161) and 52.2% (84/161) patients of all cases. The pathological abnormality was significantly negatively correlated with viral level in HBeAg-positive subjects, and based on ROC curve analysis, the viral level to predict obvious liver pathological changes was 6.7 log10 IU/ml in those patients. Threshold value of ALT (25 U/L) based on the distribution of ALT and virus levels. Patients younger than 30 years old, almost all had significant pathological alteration with HBV-DNA < 6.7 log10 IU/ml; However, the ratio of insignificant liver’s inflammation and fibrosis were 65% and 70% with HBV-DNA levels ≥ 6.7 log10 IU/ml respectively, on that basis, it could have a further rising, reaching 67.5% and 75% combining with ALT ≤ 25 U/L. Conclusion: Viral load was a better factor to reflect hepatic histological abnormality in Chronic HBV-infected patients with HBeAg-positive and persistently normal ALT whose age ≤ 30 years, 5000000 IU/ml was a suitable threshold.

scholarly journals Parameters Associated with Significant Liver Histological Changes in Patients with Chronic Hepatitis B

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Li Xiao ◽  
Jianchun Xian ◽  
Yang Li ◽  
Aiwen Geng ◽  
Xiuzhen Yang ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Hbv Dna ◽  
Advanced Fibrosis ◽  
Histological Changes ◽  
Factors Associated ◽  
Liver Histopathology ◽  
Liver Biopsies ◽  
Chronic Hbv ◽  
Normal Alt

This study aimed to evaluate factors associated with significant liver histological changes. Liver biopsies from 157 CHB patients were retrospectively analyzed. Only ALB was significantly correlated with advanced liver necroinflammatory (P=0.001). Age, ALB, GLOB, AST, PLT, and PT were independent predictors of significant fibrosis (P=0.002, P<0.001, P=0.001, P=0.048, P<0.001, and P=0.001, resp.). AST, WBC, and HBV DNA were significantly correlated with advanced fibrosis in normal ALT patients (P<0.001, P=0.041, and P=0.012, resp.) and age, ALB, GLOB, PLT, and PT in patients with abnormal ALT (P=0.003, P<0.001, P=0.004, P<0.001, and P=0.002, resp.). Age, AST, GGT, PLT, and PT were significantly associated with advanced fibrosis in HBeAg+ patients (P=0.01, P=0.016, P=0.027, P=0.016, and P=0.009, resp.) and ALB, GLOB, WBC, PLT, and PT in HBeAg− patients (P<0.001, P=0.004, P=0.005, P<0.001, and P=0.035, resp.). PLT was an excellent predictor for cirrhosis (P<0.001 and AUROC=0.805). ALT was not predictive of advanced fibrosis for patients with HBeAg+ or HBeAg− (P=0.273 and P=0.599, resp.). PLT was an excellent predictor for cirrhosis in CHB patients. Liver histopathology can be recommended for chronic HBV carriers of older age, with normal ALT, lower PLT, and lower ALB.

scholarly journals Clinical Diagnostic Value of Quantitative Hepatitis B Virus Core Antibody Test in Chronic Viral Hepatitis B

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xi Su ◽  
Huangping Chen ◽  
Zifei Zhu ◽  
Wanying Xie ◽  
Jianqiao Peng ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Antibody Test ◽  
Diagnostic Value ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Quantitative Detection ◽  
Roc Curve Analysis ◽  
Chronic Hbv Infection ◽  
Chronic Hbv

The level of CHB virus (HBV) core antibody (HBcAb) is different in four stages of chronic HBV infection and may be used for differential diagnosis of the natural history of chronic HBV infection. To address this question, we examined multiple blood biomarkers and assessed the efficacy to diagnose different stages of chronic HBV infection. The quantitative detection of HBcAb, hepatitis B surface antigen (HBsAg), HBV DNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and platelet count (PLT) were determined in the serum of 73 cases of low-replicative phase (LR), 46 cases of immune-tolerant phase (IT), 44 cases of immune clearance phase (IC), and 57 cases of HBeAg-negative hepatitis (ENH). Differentiating performance of these serum protein levels was analyzed by receiver operating characteristic (ROC) curve analysis. Our results showed that the levels of HBcAb, ALT, and AST levels were significantly higher in IC and ENH than those in LR and IT (both P ≤ 0.001 ). The levels of HBV DNA and HBsAg were higher in IC and IT than those in LR and ENH (both P ≤ 0.001 ). Logistic regression models showed that HBcAb, HBsAg, HBV DNA, ALT, and AST were the independent variables, respectively, and when combined, they provided high diagnostic accuracy for the staging of CHB. To sum up, HBcAb quantification is a new index, which can reflect whether the liver is in the immune activation state of HBV infection, and is related to the inflammatory state of the host liver. The combined detection of HBcAb quantification and other indicators has showed promising efficiency for staging of IC and ENH and can assist the diagnosis and treatment of CHB.

scholarly journals Evaluation of a Hepatitis B Virus Reactivation Prevention Program in Lymphoma Patients Receiving Immunochemotherapy

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1801-1801
Author(s):  
Blanca Sanchez-Gonzalez ◽  
Montserrat Garcia-Retortillo ◽  
Teresa Murcia ◽  
Mariana Ferraro ◽  
Francesc Garcia-Pallarols ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hbv Dna ◽  
Hbv Reactivation ◽  
Antiviral Prophylaxis ◽  
B Virus ◽  
Group A ◽  
Chronic Hbv ◽  
Group B

Abstract INTRODUCTION Chemotherapy-induced hepatitis B virus (HBV) reactivation is a well-recognized complication and is a potentially life-threatening condition in cancer patients with chronic HBV (hepatitis B surface antigen [HBsAg]-positive). Rituximab has been associated with an increase in HBV reactivation in chronic HBV patients (45%) and even in patients with resolved infection (HBsAg negative and hepatitis B core antibody [anti-HBc]-positive (22%); however, the reported frequency varies among different studies. Current guidelines for management of chronic HBV recommend routine antiviral HBV prophylaxis with lymphoma before starting chemotherapy. In contrast, there is little evidence-based consensus regarding patients with resolved HBV infection. Aim: To analyze the incidence of HBV reactivation and the role of antiviral HBV prophylaxis in lymphoma patients with chronic HBV or resolved HBV treated with chemotherapy, immunotherapy or immunochemotherapy managed according to our institutional HBV guidelines. Secondary endpoints were to analyze the incidence of HBV in this population and HBV guidelines adherence. PATIENTS AND METHODS Lymphoma patients with chronic HBV or resolved HBV in a single center. HBV viral status definitions: Active Chronic HBV infection: HBsAg positive, anti-HBc positive and HBV DNA >2000 IU/mL; Inactive Carriers: HBsAg positive, Anti-HBc positive, HBV DNA undetectable or <2000 IU/mL with normal transaminases; Resolved HBV: HBsAg negative, anti-HBc positive, HBV DNA undetectable. HBV reactivation was defined as increased serum HBV DNA (≥1 log10), regardless of liver biochemistry or HBsAg status. Institutional HBV guidelines: serum samples were collected at baseline for HBsAg and anti-HBc testing in all lymphoma patients. Patients were evaluated by a hepatologist if any of them fulfilled HBV viral status definition. Baseline at screening and monitoring every 3 months during therapy and up to 24 months after completing therapy (assessment of liver biochemistry, serum HBV DNA, HBsAg and anti-HBs levels). Specific prophylaxis strategies according to HBV status: Group A (Active chronic HBV): treatment for HBV; Group B (Inactive carriers): antiviral HBV prophylaxis; Group C (Resolved HBV): antiviral HBV prophylaxis if rituximab containing-therapy or follow-up only if rituximab-free therapy. HBV antiviral prophylaxis was started before therapy and finished 12 months after completing therapy. RESULTS From January 2012 to January 2015, 227 lymphoma patients received chemotherapy or immunochemotherapy. 142 (63%) patients received rituximab-containing therapy. 43 (19%) patients were anti-HBc positive. Group A: 2 (1%) patients; Group B: 2 (1%) patients; Group C: 39 (17%) patients. 14 (6%) patients have coinfection with hepatitis C virus and 12 (5%) patients co-infection with human immunodeficiency virus (HIV). Adherence to HBV guidelines was 90%. Patients in Group A (n=2) and B (n=2) received antiviral treatment/prophylaxis before starting therapy. In the Group C, 16 (41%) patients underwent only follow-up and 23 (59%) patients received HBV antiviral prophylaxis (lamivudine in 4, entecavir in 8 and tenofovir in 11). Median duration of HBV prophylaxis was 18 months (95% CI: 16-19 months). After a median follow-up of 21 months, 2 patients developed HBV reactivation during lymphoma treatment: 1 from group B (reactivation rate of 50%) and 1 from group C (reactivation rate of 3%). Both patients had received rituximab-containing treatment and both developed HBV reactivation (without hepatitis flare) within the first 6 months after finishing antiviral HBV prophylaxis (delayed HBV reactivation). Outcome was favorable in both patients. Characteristics of HBV reactivation patients are shown in table I. Cumulative incidence of HBV reactivation at 12 and 24 months were 0% and 8%, respectively. CONCLUSION Our strategy of close monitoring patients with chronic HBV or resolved HBV that receive chemotherapy and adding antiviral HBV prophylaxis only in selected patients clearly decrease HBV reactivation. Nevertheless, this strategy may not fully protect patients from late HBV reactivations. Larger validation studies are needed to confirm our data and to establish the best cost-effective strategy in this lymphoma population, especially in the new era of inmunomodulatory drugs of their real involvement in HBV reactivation is unknown. Table 1 Table 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Sequential HBV Treatment With Tenofovir Alafenamide for Patients With Chronic Hepatitis B: Week 96 Results From a Real-world, Multicenter Cohort Study

2021 ◽  
Author(s):  
Eiichi Ogawa ◽  
Makoto Nakamuta ◽  
Toshimasa Koyanagi ◽  
Aritsune Ooho ◽  
Norihiro Furusyo ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Cohort Study ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Hbv Dna ◽  
Multicenter Cohort Study ◽  
Previously Treated ◽  
Tenofovir Alafenamide ◽  
Almost All ◽  
Renal Safety

Abstract Background and AimsOutcome data of sequential hepatitis B virus treatment with tenofovir alafenamide (TAF) are limited. We aimed to assess the effectiveness and renal safety of TAF in chronic hepatitis B (CHB) patients who were previously treated with entecavir (ETV), tenofovir disoproxil fumarate (TDF), or nucleos(t)ide analog (NA) combination. MethodsThis multicenter, retrospective, cohort study included 458 consecutive CHB patients who switched to TAF monotherapy after at least two years of treatment with another NA. The longitudinal virological/laboratory responses were evaluated up to 96 weeks after switchover. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR)<60 mL/min/1.73m2. ResultsThe proportions of HBV DNA suppression (HBV DNA<20 IU/mL) at week 96 were 99.0%, 97.8%, and 98.4% in the prior ETV (n=198), TDF (n=137), and NA combination (n=123) groups, respectively. Almost all patients with HBV DNA of 20-2000 IU/mL at baseline achieved HBV DNA suppression at week 96. On multivariable generalized estimated equation (GEE) analysis, a low quantitative hepatitis surface antigen (qHBsAg) level at baseline was associated with a lower follow-up qHBsAg level (coefficient 0.81, P<0.001). The eGFR showed greater improvement in patients with CKD compared to those with non-CKD according to the multivariable GEE analysis (coefficient 21.7, P<0.001). However, the increase of eGFR reached a peak between weeks 24 and 48. ConclusionsBased on this longitudinal data analysis up to 96 weeks, sequential NA therapy with a switch to TAF is a good option to better achieve high viral suppression and renal safety.

Could serum HBV DNA level in the early phase of acute hepatitis predict evolution to chronic HBV carriage?

1997 ◽  
Vol 26 (4) ◽  
pp. 953-954 ◽  
Author(s):  
Philippe Roingeard ◽  
Frédéric Dubois ◽  
Yannick Bacq ◽  
Francis Barin ◽  
Alain Goudeau
Keyword(s):  
Acute Hepatitis ◽  
Early Phase ◽  
Hbv Dna ◽  
Chronic Hbv

An Alternative Approach for Evaluating the Binormal ROC Curve

2013 ◽  
Vol 4 (1) ◽  
pp. 1-17 ◽  
Author(s):  
R. Amala ◽  
R. Vishnu Vardhan
Keyword(s):  
Roc Curve ◽  
Error Function ◽  
False Positive Rate ◽  
True Positive Rate ◽  
Roc Curve Analysis ◽  
New Approach ◽  
Alternative Approach ◽  
Positive Rate ◽  
Almost All ◽  
Two Populations

In recent years the ROC curve analysis has got its attention in almost all diversified fields. Basing on the data pattern and its distribution various forms of ROC models have been derived. In this paper, the authors have assumed that the data of two populations (healthy and diseased) follows normal distribution, it is one of the most commonly used forms under parametric approach. The present paper focuses on providing an alternative approach for the tradeoff plot of ROC curve and the computation of AUC using a special function of sigmoid shape called Error function. It is assumed that the test scores of particular biomarker are normally distributed. The entire work has been carried out for providing a new approach for the construction of Binormal ROC curve, which makes use of Error function which can be called as ErROC curve. The summary measure AUC of the resulting ErROC curve has been estimated and defined as ErAUC. The authors have also focused on deriving the expression for obtaining the optimal cut-off point. The new ErROC curve model will provide the true positive rate value at each and every point of false positive rate unlike conventional Binormal ROC model.

scholarly journals Spectrum of Hepatits B Infection Among Patients Attending Liver Unit in Nepalgunj Medical College – Kohalpur

2018 ◽  
Vol 16 (2) ◽  
pp. 2-5
Author(s):  
Dipendra Khadka ◽  
Sudhamshu KC ◽  
Niyanta Karki ◽  
Sandip Khadka ◽  
Kiran Regmi
Keyword(s):  
Liver Disease ◽  
Hepatitis B ◽  
Tertiary Care ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Hepatitis B Infection ◽  
Chronic Hbv Infection ◽  
Medical College ◽  
Liver Unit ◽  
Chronic Hbv

Introduction: Hepatitis B infection is a global problem. Hepatitis B virus (HBV) infection related liver disease is also not an uncommon problem in our country too. Reports regarding pattern of chronic HBV infection are also lacking. The aim of the present study was to determine the spectrum of chronic HBV infection among patients attending the liver clinic in a tertiary care center. Method: A hospital based descriptive cross-sectional study was carried out in Liver unit of Nepalgunj Medical College, Kohalpur, from April 2018 to November 2018. All patients with HBsAg positive were further tested for HBeAg, HBeAb, HBV DNA quantitative and liver function test. Ultrasound examination was advised for any evidence of chronic liver disease. Staging was done according to viral serology, liver biochemistry and ultrasonography of liver Results: Total patients enrolled were 119. Majority of patents were in between 30-60 years (51.3%) with male predominance 59.7%. Most of patients were in the stage of HBeAg negative chronic infection 66.4% with normal transaminase and HBV DNA <2000 IU/ML. Majority of patients having unknown source of infection 90.8%. Incidental detection (67.2%) was common mode of detection. Conclusions: Majority of patients were in HBeAg negative chronic hepatitis B infection phase with normal transaminase and low HBV DNA not requiring treatment.

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