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Conference Paper: HBV DNA levels predict significant liver histology for HBeAg-negative chronic hepatitis B patients
Title | HBV DNA levels predict significant liver histology for HBeAg-negative chronic hepatitis B patients |
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Authors | |
Issue Date | 2010 |
Publisher | WB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro |
Citation | The 2010 Digestive Disease Week (DDW 2010), New Orleans, LA., 1-5 May 2010. In Gastroenterology, 2010, v. 138 n. 5 supp1, p. S-788 How to Cite? |
Abstract | Background: Current treatment guidelines recommend liver biopsies for hepatitis B e antigen
(HBeAg) negative chronic hepatitis B (CHB) patients with a high viral load but an alanine
aminotransferase (ALT) less than 2 times the upper limit of normal before considering
antiviral therapy. Aim: To determine any association between high HBV DNA levels and
significant liver histology in both HBeAg-positive and HBeAg-negative patients. Methods:
From 1994 to 2008, liver biopsy was performed on 313 treatment-naïve CHB patients.
Histological assessment was based on the Knodell histologic activity index (HAI) for necroinflammation
and the Ishak fibrosis staging for fibrosis. Pre-biopsy liver function, HBeAg status
and HBV DNA levels were checked. Results: 205 HBeAg positive and 108 HBeAg negative
patients were recruited, with a median age of 31 (range: 16-60) and 46 (range 18-63)
respectively. An elevated HBV DNA was predictive of significant fibrosis (Ishak fibrosis stage
≥3, p<0.001) and significant necroinflammation (Knodell HAI ≥8, p=0.002) for HBeAgnegative
CHB. While older age is associated with significant fibrosis for all CHB patients
(p=0.001), a high viral load predicted significant fibrosis in HBeAg-negative patients with
age <40 years (p<0.001) or ≥40 years (p=0.009). HBV DNA levels failed to predict liver
histology in HBeAg-positive patients. An elevated ALT was associated with significant necroinflammation
(p=0.002), but was not predictive of significant fibrosis for both HBeAg-positive
and -negative patients. Conclusion: High HBV DNA levels were predictive of advanced liver
histology in HBeAg- negative CHB but not in HBeAg-positive CHB, and may guide decisions
regarding antiviral therapy for HBeAg-negative patients. |
Persistent Identifier | http://hdl.handle.net/10722/224207 |
ISSN | 2023 Impact Factor: 25.7 2023 SCImago Journal Rankings: 7.362 |
DC Field | Value | Language |
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dc.contributor.author | Seto, WKW | - |
dc.contributor.author | Lai, CL | - |
dc.contributor.author | Fung, JYY | - |
dc.contributor.author | Yuen, JCH | - |
dc.contributor.author | Wong, DKH | - |
dc.contributor.author | Yuen, RMF | - |
dc.date.accessioned | 2016-03-29T08:55:36Z | - |
dc.date.available | 2016-03-29T08:55:36Z | - |
dc.date.issued | 2010 | - |
dc.identifier.citation | The 2010 Digestive Disease Week (DDW 2010), New Orleans, LA., 1-5 May 2010. In Gastroenterology, 2010, v. 138 n. 5 supp1, p. S-788 | - |
dc.identifier.issn | 0016-5085 | - |
dc.identifier.uri | http://hdl.handle.net/10722/224207 | - |
dc.description.abstract | Background: Current treatment guidelines recommend liver biopsies for hepatitis B e antigen (HBeAg) negative chronic hepatitis B (CHB) patients with a high viral load but an alanine aminotransferase (ALT) less than 2 times the upper limit of normal before considering antiviral therapy. Aim: To determine any association between high HBV DNA levels and significant liver histology in both HBeAg-positive and HBeAg-negative patients. Methods: From 1994 to 2008, liver biopsy was performed on 313 treatment-naïve CHB patients. Histological assessment was based on the Knodell histologic activity index (HAI) for necroinflammation and the Ishak fibrosis staging for fibrosis. Pre-biopsy liver function, HBeAg status and HBV DNA levels were checked. Results: 205 HBeAg positive and 108 HBeAg negative patients were recruited, with a median age of 31 (range: 16-60) and 46 (range 18-63) respectively. An elevated HBV DNA was predictive of significant fibrosis (Ishak fibrosis stage ≥3, p<0.001) and significant necroinflammation (Knodell HAI ≥8, p=0.002) for HBeAgnegative CHB. While older age is associated with significant fibrosis for all CHB patients (p=0.001), a high viral load predicted significant fibrosis in HBeAg-negative patients with age <40 years (p<0.001) or ≥40 years (p=0.009). HBV DNA levels failed to predict liver histology in HBeAg-positive patients. An elevated ALT was associated with significant necroinflammation (p=0.002), but was not predictive of significant fibrosis for both HBeAg-positive and -negative patients. Conclusion: High HBV DNA levels were predictive of advanced liver histology in HBeAg- negative CHB but not in HBeAg-positive CHB, and may guide decisions regarding antiviral therapy for HBeAg-negative patients. | - |
dc.language | eng | - |
dc.publisher | WB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro | - |
dc.relation.ispartof | Gastroenterology | - |
dc.title | HBV DNA levels predict significant liver histology for HBeAg-negative chronic hepatitis B patients | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Seto, WKW: wkseto@hku.hk | - |
dc.identifier.email | Lai, CL: hrmelcl@hku.hk | - |
dc.identifier.email | Fung, JYY: jfung@sicklehut.com | - |
dc.identifier.email | Yuen, JCH: jchyuen@HKUCC.hku.hk | - |
dc.identifier.email | Wong, DKH: danywong@hku.hk | - |
dc.identifier.email | Yuen, RMF: mfyuen@hkucc.hku.hk | - |
dc.identifier.authority | Seto, WKW=rp01659 | - |
dc.identifier.authority | Lai, CL=rp00314 | - |
dc.identifier.authority | Fung, JYY=rp00518 | - |
dc.identifier.authority | Wong, DKH=rp00492 | - |
dc.identifier.authority | Yuen, RMF=rp00479 | - |
dc.identifier.hkuros | 174666 | - |
dc.identifier.volume | 138 | - |
dc.identifier.issue | 5 suppl. 1 | - |
dc.identifier.spage | S-788 | - |
dc.identifier.epage | S-788 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0016-5085 | - |