慢性乙型肝炎病毒感染和正常转氨酶患者肝纤维化程度的表

StephenW

Clin Mol Hepatol. 2018 Jul 4. doi: 10.3350/cmh.2018.0004. [Epub ahead of print]
Characterization and evaluation of liver fibrosis grade in patients with chronic hepatitis B virus infection and normal transaminases.
Cristina SJL1, Marta CM1, Mercedes GS1, Almudena PM1, Álvaro HM1, Luis VSJ1, Tesifón PC2.
Author information

1
    Department of Digestive Diseases, Torrecárdenas Hospital, University of Almería, Almería, Spain.
2
    Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain.

Abstract
Backgrounds/Aims:

The objective of our study was to determine the epidemiological, laboratory, and serological characteristics of patients with chronic hepatitis B virus (HBV) infection and normal transaminases. The study also aimed to evaluate liver damage by measuring the liver fibrosis (LF) grade and to identify possible factors associated with the presence of fibrosis.
Methods:

A retrospective observational study was conducted in patients with chronic HBV infection and classified as inactive carriers or immune-tolerant. Epidemiological variables of age, sex, immigrant, alcohol consumption, and body mass index (BMI), as well as virological variables (HBV DNA) and transaminase level were collected throughout the follow-up. The LF grade was evaluated by transient elastography. The cutoff value for significant fibrosis (SF) was liver stiffness ≥7.9 kPa.
Results:

A total of 214 patients were included in the analysis, and 62% of them had a BMI ≥25 kg/m2 . During follow-up, 4% of patients showed transaminase elevation (<1.5 times normal). Most patients had a viral DNA level <2,000 IU/mL (83%). Data on LF were available in 160 patients; of these, 14% had SF, 9% F3, and 6% F4. The variables associated with the presence of SF were transaminase alteration during follow-up, as 23% of patients with SF had elevated transaminases versus 3% of patients without SF (P<0.005), and BMI, as the vast majority of patients with SF (88%) had a BMI ≥25 kg/m2 versus 56% of patients without SF (P<0.05).
Conclusions:

In patients with chronic HBV infection and normal transaminases, liver damage does not seem to be related to DNA levels, alcohol consumption, or immigrant status. SF seems to be associated with transaminase alteration during follow-up and elevated BMI. It is therefore recommended to measure LF grade with validated non-invasive methods in such patients.
KEYWORDS:

Elastography; Hepatitis B e Antigens; Liver fibrosis; Chronic hepatitis B virus infection

PMID:
    29969885
DOI:
    10.3350/cmh.2018.0004

StephenW

Clin Mol Hepatol。 2018年7月4日doi：10.3350 / cmh.2018.0004。 [提前打印]
慢性乙型肝炎病毒感染和正常转氨酶患者肝纤维化程度的表征和评价。
Cristina SJL1，Marta CM1，Mercedes GS1，Almudena PM1，ÁlvaroHM1，Luis VSJ1，TesifónPC2。
作者信息

1
    西班牙阿尔梅里亚阿尔梅里亚大学Torrecárdenas医院消化系。
2
    西班牙阿尔梅里亚阿尔梅里亚大学护理，物理治疗和医学系。

抽象
背景/目标：

我们的研究目的是确定慢性乙型肝炎病毒（HBV）感染和正常转氨酶患者的流行病学，实验室和血清学特征。该研究还旨在通过测量肝纤维化（LF）等级来评估肝损伤，并确定与纤维化存在相关的可能因素。
方法：

对慢性HBV感染患者进行了一项回顾性观察研究，并将其归类为非活动性携带者或免疫耐受者。在整个随访期间收集了年龄，性别，移民，饮酒量和体重指数（BMI）以及病毒学变量（HBV DNA）和转氨酶水平的流行病学变量。通过瞬态弹性成像评估LF等级。显着纤维化（SF）的临界值是肝硬度≥7.9kPa。
结果：

共纳入214例患者，其中62％患者的BMI≥25kg/ m2。在随访期间，4％的患者显示转氨酶升高（<正常值的1.5倍）。大多数患者的病毒DNA水平<2,000 IU / mL（83％）。 160名患者可获得LF数据;其中，14％有SF，9％F3和6％F4。与SF存在相关的变量是随访期间的转氨酶改变，因为23％的SF患者转氨酶升高而3％的患者没有SF（P <0.005），而BMI，绝大多数SF患者（88％）BMI≥25kg/ m2，而没有SF的患者为56％（P <0.05）。
结论：

在慢性HBV感染和转氨酶正常的患者中，肝损伤似乎与DNA水平，饮酒或移民状态无关。 SF似乎与随访期间转氨酶改变和BMI升高有关。因此，建议在此类患者中使用经过验证的非侵入性方法测量LF等级。
关键词：

弹性;乙型肝炎e抗原;肝纤维化;慢性乙型肝炎病毒感染

结论：
    29969885
DOI：
    10.3350 / cmh.2018.0004