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Pathological changes of liver one year later in CHB patients with negative HBV DNA
Wu Shanshan1, Du Xinfang2, Yu Shuihong3
11State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, 310003 Hangzhou China.
Insights
Negative HBV DNA does not guarantee controlled Hepatitis B. Patients with rising HBV DNA during antiviral therapy risk disease progression, necessitating vigilant monitoring of viral load, liver function, and AFP levels.
Area of Science:
- Hepatology
- Virology
- Pathology
Background:
- Chronic Hepatitis B (CHB) management requires understanding hepatic changes during antiviral therapy.
- Investigating pathological alterations in HBV DNA-negative CHB patients post-treatment is crucial.
Purpose of the Study:
- To determine hepatic pathological changes in CHB patients initially negative for HBV DNA after 12 months of antiviral therapy.
- To compare outcomes between patients remaining HBV DNA-negative and those becoming HBV DNA-positive during treatment.
Main Methods:
- Patients were categorized based on HBV DNA levels at baseline and 12-month follow-up (Group A: persistently negative; Group B: negative to positive).
- Assessed blood routine indicators (PLT, WBC), coagulation function (PT, PTA), HBV DNA, AFP, and viral serological markers.
- Liver biopsy tissues were analyzed for pathological changes.
Main Results:
- Group A showed significant improvement in inflammation grade (P<0.05) and decreased disease progression.
- Group B exhibited increased inflammation grade, liver function indices, and PTA (P<0.05), with a higher proportion of disease progression.
- Significant differences in AFP levels were observed between progressing patients in Group A and Group B.
Conclusions:
- Sustained HBV DNA negativity does not equate to controlled Hepatitis B.
- Hepatitis B patients who become HBV DNA positive during antiviral therapy are prone to disease progression.
- Close monitoring of HBV DNA, liver function, PTA, and AFP is vital for timely detection of disease changes.
Background:
In this study, we aim to determine the hepatic pathological changes in HBV DNA-negative chronic Hepatitis B (CHB) patients after 12-month antiviral therapy.
Methods:
Blood routine indicators including platelet count (PLT) and white blood cell (WBC) were determined. The coagulation function was evaluated by determining the prothrombin time (PT) and prothrombin time activity (PTA), together with the HBV DNA quantification and alpha fetoprotein (AFP). The virology data included hepatitis B surface antigen (HBsAg)/antibodies against hepatitis B surface antigen (anti-HBs), hepatitis B e antigen (HBeAg)/antibodies against hepatitis B e antigen (anti-HBe) and antibodies against hepatitis B core antigen (anti-HBc) were tested. Pathological assay was performed to the liver puncture tissues. Based on the HBV DNA data in the 12-month follow-up of the cases that received anti-viral therapy during this time, the experimental group was divided into group A (HBV DNA negative at the baseline level, HBV DNA negative after 12 months, N = 79) and group B (HBV DNA negative at the baseline level, HBV DNA turning to be positive after 12 months, N = 13). Statistical analysis was performed on the each test index of the two groups.
Results:
The inflammation grade of group A showed significant improvement after 12-month treatment (P < 0.05). The pathological inflammation grade of group B was increased after one year, and the liver function indices and the PTA (P < 0.05) levels were all increased. Pathological results indicated that the proportion of disease progression in group A was decreased after 12-month follow-up while that proportion was increased in group B. Significant differences were noticed in AFP levels between the patients with progression in group A and those with progression in group B.
Conclusion:
Negative HBV DNA does not mean a controlled hepatitis B. Hepatitis B patients transferred to HBV DNA positivity during the anti-viral therapy are easily to show disease progression, and then special attention should be paid to the HBV DNA monitoring. Meanwhile, close monitoring to the changes of liver function, PTA and AFP levels may help to detect changes on the disease in a timely manner.
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