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[Chronic changes in the liver in our patients]
1Gastroenterologic Division, Detroit, Michigan, USA.
Insights
Hepatitis B virus (HBV) infection and alcohol are key causes of chronic liver damage. Many patients with chronic liver disease require only monitoring, not active therapy, preserving their work capacity.
Area of Science:
- Hepatology
- Virology
- Public Health
Context:
- Hepatitis B virus (HBV) infection and alcohol consumption are primary etiological factors in chronic liver parenchyma damage.
- Accurate patient selection for chronic liver disease management relies on hepatitis markers (HBsAg, HBeAg) and aminotransferase levels.
Purpose:
- To evaluate the necessity of therapy for patients with chronic liver damage based on diagnostic markers.
- To establish criteria for managing patients with chronic liver damage to reduce costs and work absence.
Summary:
- Hepatitis B virus (HBV) infection and alcohol are the most significant causes of chronic liver damage.
- Patient selection for chronic liver disease should involve hepatitis markers and aminotransferase activity.
- Over half of patients with chronic liver damage may not require therapy and can maintain work capacity with regular monitoring.
Impact:
- Implementing standardized diagnostic and management criteria can decrease healthcare costs and reduce unnecessary work absenteeism.
- Preventive strategies, including HBV vaccination and combating alcoholism, are crucial for preventing chronic liver damage.
Abstract:
VHB infection together with alcohol ist the most important ethiologic factor in the genesis of chronic liver parenchyma damage in our sample. Selection of patients with chronic diseases of the liver should be done on the basis of hepatitis markers determination, that is on the presence of HBsAg and HBeAg and the activity of aminotransferases in blood. Doing this it can be seen that more that half of the patients with chronic liver damage do not need therapy, and they have work capacity preserved. In these cases occasional controls of hepatitis markers and the level of AT in blood are needed. Presence of the virus replication can be determined on the basis of presence of the HBeAg in blood and HBcAg in the hepatocyte nucleus (histologic assay), since HBV-DNA and HBV-DNA polymerases in blood are not determined in the day's routine. Biopsy and rebiopsy of the liver tissue (pathohistologic assay) is the only confident my to determine the degree of liver damage. Introducing of the unique criteria in the management of the patients who have the signs of chronic liver damage would lower the diagnosis and treatment costs, as well as the unnecessary patient's absence from work. Proceeding of the preventive measures, vaccination of the persons who are exposed to VHB infection, as well as the struggle against alcoholism, stay on as the main source in prevention of chronic liver damage genesis.