Geng XX, Lin JM, Yang XX, Huang RG, Jiang N. Liver histopathology and clinical manifestations in patients with chronic HBV infection: an analysis of 128 cases.
Shijie Huaren Xiaohua Zazhi 2009;
17:2099-2104. [DOI:
10.11569/wcjd.v17.i20.2099]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the liver histopathological changes and clinical features between chronic HBV carriers and chronic hepatitis B patients with mildly elevated serum alanine aminotransferase (ALT), and explore factors affecting liver histopathological changes.
METHODS: One hundred and twenty-eight patients were divided into three groups according to serum ALT levels: Group A (ALT level ≤ 0.5 × upper limits of normal (ULN)), Group B (0.5 × ULN < ALT level ≤ 1 × ULN) and Group C (1 × ULN < ALT level < 2 × ULN). The age, sex, serum HBV-DNA level, HBeAg status, positive rate of HBcAg, thickness of spleen, width of portal vein, grade of liver inflammation and stage of liver fibrosis in the three groups were compared. The changes in these clinical parameters were then observed in patients whose liver had different histopathological changes.
RESULTS: Of 128 patients, 44.5% had G1 hepatitis and 55.5% had G2 hepatitis; 56.3% had S1 fibrosis, 23.4% had S2 fibrosis and 20.3% had no liver fibrosis. There were no significant differences in age, sex, serum HBV DNA level, HBeAg status, expression of HBcAg in liver and width of portal vein among Group A, B and C (all P > 0.05). And there was a significant difference in thickness of spleen between Group C and A, as well as between Group C and B (P < 0.01). The aggravation of liver inflammation was correlated with a significant increase in serum ALT level, thickness of spleen, width of portal vein and positive rate of HBcAg (all P < 0.05). Moreover, the aggravation of liver fibrosis was correlated with a significant increase in the thickness of spleen, breadth of portal vein and negative rate of HBeAg (all P < 0.05).
CONCLUSION: Patients with chronic HBV infection (ALT < 2×UNL) often show varying degrees of liver inflammation, with or without liver fibrosis. Close monitoring of serum ALT, thickness of spleen, width of portal vein and positive rate of HBcAg in liver may be able to help understand histopathological changes in the liver.
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