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High prevalence of significant histology in asymptomatic chronic hepatitis B patients with genotype C and high serum HBV DNA levels

Authors
 J. Y. Park  ;  Y. N. Park  ;  D. Y. Kim  ;  Y. H. Paik  ;  K. S. Lee  ;  B. S. Moon  ;  K.-H. Han  ;  C. Y. Chon  ;  S. H. Ahn 
Citation
 JOURNAL OF VIRAL HEPATITIS, Vol.15(8) : 615-621, 2008 
Journal Title
 JOURNAL OF VIRAL HEPATITIS 
ISSN
 1352-0504 
Issue Date
2008
MeSH
Adolescent ; Adult ; Aged ; Alanine Transaminase/blood ; Asymptomatic Diseases/epidemiology* ; Biopsy ; DNA, Viral/blood* ; DNA, Viral/genetics ; Female ; Genotype ; Hepatitis B virus/genetics ; Hepatitis B virus/isolation & purification* ; Hepatitis B, Chronic/epidemiology* ; Hepatitis B, Chronic/pathology* ; Histocytochemistry ; Humans ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/pathology* ; Male ; Middle Aged ; Prevalence ; Serum/virology ; Severity of Illness Index ; Viral Load ; Young Adult
Keywords
alanine aminotransferase ; chronic hepatitis B ; HBV DNA ; liver histology
Abstract
Current treatment guidelines suggest that antiviral therapy be considered for chronic hepatitis B (CHB) patients with high viral load if a biopsy shows significant liver disease despite alanine aminotransferase (ALT) levels two times or less than the upper limit of normal (ULN). We evaluated the histological findings in CHB patients with high viral load and persistently normal or slightly elevated serum ALT levels. Between January 2003 and June 2006, 105 consecutive treatment-naive patients with CHB who underwent ultrasonography-guided percutaneous liver biopsy, had detectable serum HBV DNA (>10(5) copies/mL) in a direct hybridization assay and normal or slightly elevated serum ALT levels (≤2 × ULN) for at least 12 months were included in a prospective study. Histological assessment was based on the METAVIR scoring system. Significant histology was defined as fibrosis stage ≥F2 or necroinflammation grade ≥A2. Among the 105 CHB patients with high viral load and persistently normal or slightly elevated serum ALT levels for at least 12 months, significant fibrosis (F2-F4 fibrosis) was observed in 63 patients (60.0%) and the actual significant histology was found in 65 patients (61.9%). On multivariate analysis, serum ALT levels and age at which they entered the study were independent factors associated with significant histology. Odds ratios for significant histology increased progressively according to serum ALT levels and age. In conclusion, a large proportion of CHB patients with genotype C, high viral load and ALT ≤2 × ULN had significant liver disease on liver biopsy and should be considered for antiviral therapy.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2008.00989.x/abstract
DOI
10.1111/j.1365-2893.2008.00989.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Moon, Byung Soo(문병수)
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Paik, Yong Han(백용한)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Kwan Sik(이관식) ORCID logo https://orcid.org/0000-0002-3672-1198
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107127
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