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Published on: February 19, 2019
[A study on the hepatic histological changes and clinical manifestations in chronic HBV carriers]
1Sixth People's Hospital of Shenyang, Shenyang 110006, China. weini2388@hotmail.com
Insights
This study on chronic hepatitis B (HBV) carriers found mild liver inflammation and high HBV DNA replication. Liver inflammation grade correlates with fibrosis, but not HBV DNA levels or HBeAg status.
Area of Science:
- Hepatology
- Virology
- Immunology
Context:
- Chronic hepatitis B virus (HBV) infection affects millions globally.
- Understanding the interplay between viral load, liver damage, and clinical markers is crucial for patient management.
- Hepatic histopathological changes provide direct insights into disease progression.
Purpose:
- To investigate the relationship between hepatic histopathological changes and clinical characteristics in chronic HBV carriers.
- To assess correlations between HBV DNA replication, HBeAg status, and liver inflammation/fibrosis.
- To explore the association of specific biochemical markers with liver pathology.
Summary:
- A retrospective analysis of 142 chronic HBV carriers revealed high HBV DNA replication (average >10^4 copies/mL) and HBeAg positivity in most cases (95.3%).
- Mild liver inflammation (G ≥ 1) was diagnosed in 106 cases, with one case showing early cirrhosis (G4S4).
- Spearman's analysis showed a correlation between inflammation grade (G) and hepatic fibrosis index PCIII (r=0.391, P=0.003), with higher PCIII in carriers with inflammation compared to non-active carriers (P=0.016).
Impact:
- Findings suggest that while inflammation grade correlates with fibrosis, it is independent of HBV DNA levels or HBeAg positivity in this cohort.
- Elevated PCIII levels may indicate active hepatic inflammation in chronic HBV carriers.
- This study contributes to understanding the histopathological landscape of chronic HBV and its clinical correlates.
Objective:
To investigate the relationship between hepatic histopathological changes and clinical characteristics in chronic HBV carriers.
Method:
A retrospective analysis was performed based on the hepatic biopsy findings, clinical laboratory results, and ultrasound examinations in 142 chronic HBV carriers. The patients were divided into two groups according to their serum HBV DNA replication and the pathological alterations in their livers.
Results:
The average age of the 142 patients was (24.8+/-8.7) years old. Among them, 129 were diagnosed as chronic HBV carriers based on their positive HBV DNA results. Thirteen were diagnosed as non-active HBsAg carriers. Hepatitis B family history was found in 31.0% of the cases. Normal liver tissues (G0S0) were found in the specimens of 33 cases (G > or = 1 and/or S > or = 1) chronic hepatitis B was diagnosed based on the biopsies in 106 cases, including an early stage of hepatic cirrhosis in 1 case (G4S4). There were no obvious differences between HBV DNA positive and negative group cases. The levels of HBV DNA in all the 129 cases of chronic HBV carriers were more than 1.0 x 10(4) copy/ml and the average value was (7.58+/-0.99) log10 copy/ml. Of the 129 cases, 123 were HBeAg positive (95.3%). Increased levels of gamma-globulin were detected in 45.8% of the cases and fibrosis index increased in 37.1%; 40.1% of the cases showed abnormalities in their ultrasound examinations. The average PCIII value of the chronic HBV carrier group (G > or = 1 and/or S > or = 1) was higher than that of the non-active HBsAg carrier group (P = 0.016). Spearman's analysis indicated that the inflammation grade (G) was correlated with the hepatic fibrosis index PCIII, and the correlation coefficient was 0.391 (P = 0.003).
Conclusion:
The patients in our study have a higher HBV DNA replication in their sera and have mild inflammation in their livers. Inflammation grade (G) and fibrosis stage (S) have no correlation with the level of HBV DNA or the state of HBeAg positivity. The increased level of PCIII might be related to their hepatic inflammation.
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