慢性乙型肝炎病毒感染HBV-DNA病毒

StephenW

PLoS One. 2018 Sep 4;13(9):e0203220. doi: 10.1371/journal.pone.0203220. eCollection 2018.
Clinical and histopathological features of chronic hepatitis B virus infected patients with high HBV-DNA viral load and normal alanine aminotransferase level: A multicentre-based study in China.
Xing YF1, Zhou DQ1, He JS1, Wei CS1, Zhong WC1, Han ZY1, Peng DT1, Shao MM2, Sham TT3, Mok DK3,4, Chan CO3,4, Tong GD1.
Author information

1
    Department of Hepatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
2
    Department of Pathology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
3
    Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China.
4
    State Key Laboratory of Chinese Medicine and Molecular Pharmacology (Incubation), Shenzhen, China.

Abstract
BACKGROUND:

The aim of this study is to reveal the clinical and histopathological features of HBsAg-positive and HBeAg-positive chronic hepatitis B infected patients with high level of HBV DNA, from 17 hospitals and medical centres in China, with alanine aminotransferase levels within the lower region of normal range versus those with levels within the upper region of normal range and to investigate the clinical risk factors for the requirement of treatment through the examination of liver biopsy.
METHODS:

Liver biopsy was performed on high level of HBV DNA of 455 patients with HBsAg-positive and HBeAg-positive chronic hepatitis B infection and persistently normal alanine aminotransferase level. Liver necroinflammation and fibrosis were graded per the Knodell histological activity index and Ishak's fibrosis score, respectively. Univariate analysis of the clinical parameters versus necroinflammation and fibrosis was carried out.
RESULTS:

Of the subjects in this multicentre-based study, 5.49% and 10.11% had significant necroinflammation with Knodell histological activity index ≥ 9 and hepatic fibrosis stages with Ishak scores ≥ 3, respectively. The subjects were stratified into three age groups (30-39, 40-49 and ≥ 50 years), and our data clearly suggested that age, particularly in the age group over 50, was an independent predictor of liver necroinflammation and fibrosis. Lower HBV-DNA viral levels were found in patients with Knodell histological activity index ≥ 9 or advanced fibrosis (Ishak scores ≥ 3).
CONCLUSION:

Our results showed that histological changes in liver tissues were observed in a significant proportion of patients with persistently normal alanine aminotransferase level. According to the data evaluation results, liver biopsy is advisable for HBeAg-positive chronic hepatitis B infected patients aged older than 40 and high HBV-DNA viral load in China.

PMID:
    30180183
DOI:
    10.1371/journal.pone.0203220

StephenW

PLoS One。 2018年9月4日; 13（9）：e0203220。 doi：10.1371 / journal.pone.0203220。 eCollection 2018。
慢性乙型肝炎病毒感染HBV-DNA病毒载量高和丙氨酸氨基转移酶水平正常的患者的临床和组织病理学特征：中国多中心研究。
Xing YF1，Zhou DQ1，He JS1，Wei CS1，Zhong WC1，Han ZY1，Peng DT1，Shao MM2，Sham TT3，Mok DK3,4，Chan CO3,4，Tong GD1。
作者信息

1
    深圳市中医医院肝病科，深圳
2
    深圳市中医医院病理科，深圳
3
    香港理工大学应用生物及化学科技系，中国香港。
4
    中国医药与分子药理学国家重点实验室（孵化），深圳，中国。

抽象
背景：

本研究的目的是揭示中国17家医院和医疗中心HBsAg阳性和HBeAg阳性慢性乙型肝炎患者HBV DNA水平高的临床和组织病理学特征，其中丙氨酸氨基转移酶水平在较低区域正常范围与正常范围上限范围内的水平相比，并通过检查肝活检来调查治疗要求的临床危险因素。
方法：

对455例HBsAg阳性和HBeAg阳性慢性乙型肝炎感染患者的高水平HBV DNA进行肝活检，并持续保持正常的丙氨酸氨基转移酶水平。肝脏坏死性炎症和纤维化分别根据Knodell组织学活动指数和Ishak纤维化评分进行分级。进行了临床参数与坏死性炎症和纤维化的单变量分析。
结果：

在这项基于多中心的研究中，5.49％和10.11％的患者有明显的坏死性炎症，Knodell组织学活动指数≥9，肝纤维化分期，Ishak评分≥3。受试者分为三个年龄组（30-39岁，40-49岁和≥50岁），我们的数据清楚地表明，年龄，特别是50岁以上的年龄组，是肝脏坏死性炎症和纤维化的独立预测因子。在Knodell组织学活性指数≥9或晚期纤维化（Ishak评分≥3）的患者中发现较低的HBV-DNA病毒水平。
结论：

我们的研究结果显示肝脏组织的组织学变化在很大比例的丙氨酸氨基转移酶水平持续正常的患者中观察到。根据数据评估结果，肝脏活检对于年龄大于40岁的HBeAg阳性慢性乙型肝炎患者和中国HBV-DNA病毒载量高是可取的。

结论：
    30180183
DOI：
    10.1371 / journal.pone.0203220

StephenW

https://journals.plos.org/ploson ... ournal.pone.0203220

neilhbver

感谢，再次说明单独看转氨酶真的很耽误事

antiHBVren

显示肝脏组织的组织学变化在很大比例的丙氨酸氨基转移酶水平持续正常的患者中观察到。

根据数据评估结果，肝脏活检对于年龄大于40岁的HBeAg阳性慢性乙型肝炎患者和中国HBV-DNA病毒载量高是可取的。