A., H., A., A., M., E., G., S. (2015). Liver histopathology detects more chronic hepatitis B virus genotype D patients who need to be treated. Medical Journal of Viral Hepatitis, 1.1(1), 1-14. doi: 10.21608/mjvh.2015.4565
Helmy A.; Ali A.; Elbasiony M.; Shiha G.. "Liver histopathology detects more chronic hepatitis B virus genotype D patients who need to be treated". Medical Journal of Viral Hepatitis, 1.1, 1, 2015, 1-14. doi: 10.21608/mjvh.2015.4565
A., H., A., A., M., E., G., S. (2015). 'Liver histopathology detects more chronic hepatitis B virus genotype D patients who need to be treated', Medical Journal of Viral Hepatitis, 1.1(1), pp. 1-14. doi: 10.21608/mjvh.2015.4565
A., H., A., A., M., E., G., S. Liver histopathology detects more chronic hepatitis B virus genotype D patients who need to be treated. Medical Journal of Viral Hepatitis, 2015; 1.1(1): 1-14. doi: 10.21608/mjvh.2015.4565
Liver histopathology detects more chronic hepatitis B virus genotype D patients who need to be treated
1Tropical Medicine & Gastroenterology dept., Assiut Univ. Hospital, Egypt.
2Gastrohepatology & Hepatology Unit, Internal Medicine dept., Faculty of Medicine, Mansoura
Abstract
Patients with chronic hepatitis-B-virus (HVB) infection may exhibit significant liver pathology despite alanine aminotransferase (ALT) and HBV-DNA levels below current treatment guideline’s cut-off values. This study evaluated the candidacy for HBV therapy if baseline histopathological changes were considered. Clinical, biochemical, serological, virological, and histopathological (Metavir Score) data of a cohort of 161 consecutive patients [129 (80.1 %) males, mean ± SD age 35.2 ±11.2 years, 130 (80.7% HBeAgnegative, 149 (90.1 %) genotype D] were collected and analyzed. Our results showed that significant pathology (F≥2 and/or A≥2) and significant fibrosis (F≥2 ± A≥2) were found in 98/161(60.9 %) and 81/161(50.3 %) patients respectively. Based on HBV-DNA (>2000 iu/mL or >20000 iu/mL according to HBeAg status) and ALT level >2x40 u/L (the standard cut-off value), only 36/161(22.4 %) patients were candidate for therapy. This increased to 71/161(44.1 %) patients when the new ALT cut-off values (30 u/L for males, and 19 u/L for females) were applied. Relying on either (F≥2 and/or A≥2) or (F≥2±A≥2) increases the treatment candidacy by 62/161(38.5 %) or 45/161(28 %), and further increases the candidacy for treatment by 27/161(16.8 %) or 10/161(6.2 %) patients when standard and new ALT cut-off values are applied respectively. Finally, liver histopathology is more reliable than ALT and HBV-DNA levels in the decision to treat patients with chronic HBV infection.
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