High prevalence of significant histology in asymptomatic chronic hepatitis B patients with genotype C and high serum HBV DNA levels

Junyong Park, Y. N. Park, doyoung kim, Y. H. Paik, K. S. Lee, B. S. Moon, KwangHyub Han, C. Y. Chon, SangHoon Ahn

Research output: Contribution to journalArticle

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Abstract

Current treatment guidelines suggest that antiviral therapy be considered for chronic hepatitis B (CHB) patients with high viral load if a biopsy shows significant liver disease despite alanine aminotransferase (ALT) levels two times or less than the upper limit of normal (ULN). We evaluated the histological findings in CHB patients with high viral load and persistently normal or slightly elevated serum ALT levels. Between January 2003 and June 2006, 105 consecutive treatment-naive patients with CHB who underwent ultrasonography-guided percutaneous liver biopsy, had detectable serum HBV DNA (>10 5 copies/mL) in a direct hybridization assay and normal or slightly elevated serum ALT levels (≤2 X ULN) for at least 12 months were included in a prospective study. Histological assessment was based on the METAVIR scoring system. Significant histology was defined as fibrosis stage ≥F2 or necroinflammation grade ≥A2. Among the 105 CHB patients with high viral load and persistently normal or slightly elevated serum ALT levels for at least 12 months, significant fibrosis (F2-F4 fibrosis) was observed in 63 patients (60.0%) and the actual significant histology was found in 65 patients (61.9%). On multivariate analysis, serum ALT levels and age at which they entered the study were independent factors associated with significant histology. Odds ratios for significant histology increased progressively according to serum ALT levels and age. In conclusion, a large proportion of CHB patients with genotype C, high viral load and ALT ≤2 X ULN had significant liver disease on liver biopsy and should be considered for antiviral therapy.

Original languageEnglish
Pages (from-to)615-621
Number of pages7
JournalJournal of Viral Hepatitis
Volume15
Issue number8
DOIs
Publication statusPublished - 2008 Aug 1

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Chronic Hepatitis B
Alanine Transaminase
Histology
Genotype
Viral Load
DNA
Serum
Fibrosis
Biopsy
Antiviral Agents
Liver Diseases
Liver
Therapeutics
varespladib methyl
Ultrasonography
Multivariate Analysis
Odds Ratio
Prospective Studies
Guidelines

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Infectious Diseases
  • Virology

Cite this

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title = "High prevalence of significant histology in asymptomatic chronic hepatitis B patients with genotype C and high serum HBV DNA levels",
abstract = "Current treatment guidelines suggest that antiviral therapy be considered for chronic hepatitis B (CHB) patients with high viral load if a biopsy shows significant liver disease despite alanine aminotransferase (ALT) levels two times or less than the upper limit of normal (ULN). We evaluated the histological findings in CHB patients with high viral load and persistently normal or slightly elevated serum ALT levels. Between January 2003 and June 2006, 105 consecutive treatment-naive patients with CHB who underwent ultrasonography-guided percutaneous liver biopsy, had detectable serum HBV DNA (>10 5 copies/mL) in a direct hybridization assay and normal or slightly elevated serum ALT levels (≤2 X ULN) for at least 12 months were included in a prospective study. Histological assessment was based on the METAVIR scoring system. Significant histology was defined as fibrosis stage ≥F2 or necroinflammation grade ≥A2. Among the 105 CHB patients with high viral load and persistently normal or slightly elevated serum ALT levels for at least 12 months, significant fibrosis (F2-F4 fibrosis) was observed in 63 patients (60.0{\%}) and the actual significant histology was found in 65 patients (61.9{\%}). On multivariate analysis, serum ALT levels and age at which they entered the study were independent factors associated with significant histology. Odds ratios for significant histology increased progressively according to serum ALT levels and age. In conclusion, a large proportion of CHB patients with genotype C, high viral load and ALT ≤2 X ULN had significant liver disease on liver biopsy and should be considered for antiviral therapy.",
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High prevalence of significant histology in asymptomatic chronic hepatitis B patients with genotype C and high serum HBV DNA levels. / Park, Junyong; Park, Y. N.; kim, doyoung; Paik, Y. H.; Lee, K. S.; Moon, B. S.; Han, KwangHyub; Chon, C. Y.; Ahn, SangHoon.

In: Journal of Viral Hepatitis, Vol. 15, No. 8, 01.08.2008, p. 615-621.

Research output: Contribution to journalArticle

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AU - Park, Junyong

AU - Park, Y. N.

AU - kim, doyoung

AU - Paik, Y. H.

AU - Lee, K. S.

AU - Moon, B. S.

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