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Conference Paper: HBV DNA levels predict significant liver histology for HBeAg-negative chronic hepatitis B patients

TitleHBV DNA levels predict significant liver histology for HBeAg-negative chronic hepatitis B patients
Authors
Issue Date2010
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro
Citation
Digestive Disease Week, New Orleans, LA, 1-5 May 2010. In Gastroenterology, 2010, v. 138 n. 5 Supp1, p. S-788 How to Cite?
AbstractBackground: 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 Identifierhttp://hdl.handle.net/10722/224207
ISSN
2015 Impact Factor: 18.187
2015 SCImago Journal Rankings: 7.170

 

DC FieldValueLanguage
dc.contributor.authorSeto, WKW-
dc.contributor.authorLai, CL-
dc.contributor.authorFung, JYY-
dc.contributor.authorYuen, JCH-
dc.contributor.authorWong, DKH-
dc.contributor.authorYuen, RMF-
dc.date.accessioned2016-03-29T08:55:36Z-
dc.date.available2016-03-29T08:55:36Z-
dc.date.issued2010-
dc.identifier.citationDigestive Disease Week, New Orleans, LA, 1-5 May 2010. In Gastroenterology, 2010, v. 138 n. 5 Supp1, p. S-788-
dc.identifier.issn0016-5085-
dc.identifier.urihttp://hdl.handle.net/10722/224207-
dc.description.abstractBackground: 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.languageeng-
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro-
dc.relation.ispartofGastroenterology-
dc.rightsPosting accepted manuscript (postprint): © <year>. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/-
dc.titleHBV DNA levels predict significant liver histology for HBeAg-negative chronic hepatitis B patients-
dc.typeConference_Paper-
dc.identifier.emailSeto, WKW: wkseto@hku.hk-
dc.identifier.emailLai, CL: hrmelcl@hku.hk-
dc.identifier.emailFung, JYY: jfung@sicklehut.com-
dc.identifier.emailYuen, JCH: jchyuen@HKUCC.hku.hk-
dc.identifier.emailWong, DKH: danywong@hku.hk-
dc.identifier.emailYuen, RMF: mfyuen@hkucc.hku.hk-
dc.identifier.authoritySeto, WKW=rp01659-
dc.identifier.authorityLai, CL=rp00314-
dc.identifier.authorityFung, JYY=rp00518-
dc.identifier.authorityWong, DKH=rp00492-
dc.identifier.authorityYuen, RMF=rp00479-
dc.identifier.hkuros174666-
dc.identifier.volume138-
dc.identifier.issue5 Supp1-
dc.identifier.spageS-
dc.identifier.epage788-
dc.publisher.placeUnited States-

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