J Med Virol. 2017 Jun 15. doi: 10.1002/jmv.24879. [Epub ahead of print]
Predictors of histological indication for treatment in HBeAg negative chronic HBV infection.Barut S1, Gemici Ü1, Güneş F1, Demir O2, Duygu F3. Author information 1Gaziosmanpasa University, Faculty of Medicine, Department of Infectious Diseases, Clinical Microbiology, Tokat, Turkey.2Gaziosmanpasa University, Faculty of Medicine, Department of Biostatistics.3Ankara Onkology Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology.
AbstractIn this study, we evaluated the relationship of hepatitis B virus (HBV) DNA levels with liver histology and various other liver related parameters and the predictors of histologically active liver disease requiring treatment (Histological activity ≥6 and/or grade≥2 by Ishak's classification) in patients with HBeAg negative chronic HBV infection. Demographic data, laboratory findings and liver histology findings of patients with no clinical cirrhosis who underwent liver biopsy considering HBeAg negative chronic hepatitis (HBV DNA > 2000 IU/ml) were analysed. Two hundred and fifteen patients were included in this retrospective study. Treatment indication by histologic findings were 85.7%, 61.2% and 64%, respectively, in group 1 (HBV DNA≥200,000), group 2 (HBV DNA 20,000-200,000) and group 3 (HBV DNA 2000-20,000 IU/ml) (p = 0,001). Group 1 was different from other groups in terms of aspartate aminotransferase (AST), alanine aminotransferase (ALT), fibrosis stage, necroinflammatory activity, and platelet count. Multiple logistic regression analysis revealed that, advanced age (cut-off was 46 years), higher than normal AST and HBV DNA ≥200,000 IU/ml (compared to group 3) were found to be the predictors of histologically active disease with treatment indication. Conclusively, most of the patients with HBV DNA ≥200,000 IU/ml showed treatment requiring liver injury, but also a significant portion of the patients with HBV DNA 2000-200,000 IU/ml carried an indication for treatment. Although age (>46 years) and AST (>40 IU/l) can be helpful to predict treatment requirement in patients with HBV DNA 2000-200,000 IU/ml, sufficient effort should be made to find out the significant liver damage.This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
在本研究中，我们评估了乙型肝炎病毒（HBV）DNA水平与肝脏组织学和各种其他肝脏相关参数的关系以及需要治疗的组织学活跃性肝脏疾病的预测因子（Ishak分类的组织学活性≥6和/或≥2级） ）患者HBeAg阴性慢性HBV感染。分析了不考虑HBeAg阴性慢性肝炎（HBV DNA> 2000 IU / ml）进行肝活检的临床肝硬化患者的人口统计学数据，实验室检查结果和肝组织学检查结果。这项回顾性研究纳入了215位患者。组1（HBVDNA≥200,000），第2组（HBV DNA 20,000-200,000）和第3组（HBV DNA 2000-20,000 IU / ml）的组织学检查结果分别为85.7％，61.2％和64％ p值= 0001）。组1与天冬氨酸氨基转移酶（AST），丙氨酸氨基转移酶（ALT），纤维化期，坏死性炎症活性和血小板计数方面不同。多元逻辑回归分析显示，高龄（46岁），高于正常AST，HBV DNA≥200万IU / ml（与3组相比），发现是具有治疗指征的组织学活动性疾病的预测因子。最终，大多数HBV DNA≥200万IU / ml的患者显示需要肝损伤的治疗，但是HBV DNA的重要部分2000-200,000 IU / ml也是治疗指征。虽然年龄（> 46岁）和AST（> 40 IU / l）可有助于预测HBV DNA 2000-200,000 IU / ml患者的治疗需求，但应充分努力找出显着的肝损伤。本文受版权保护。版权所有。
发表于 2017-6-17 14:08