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CLINICAL PHASES OF CHRONIC HEPATITIS B AMONG GEORGIAN PATIENTS.

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Hepatitis B virus (HBV) infection in Georgia shows high exposure but low chronic infection rates. Most patients had low viral loads and no advanced fibrosis, but 19% were unclassifiable, requiring individualized management.

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Area of Science:

  • Hepatology
  • Virology
  • Public Health

Background:

  • Hepatitis B virus (HBV) infection is a significant public health concern in Georgia.
  • Prevalence rates indicate 25.9% exposure (Anti-HBc positive) and 2.9% chronic infection (HBsAg positive).
  • Determining the clinical phase of chronic HBV is vital for prognosis and treatment initiation.

Purpose of the Study:

  • To characterize clinical data of HBV-infected patients in Georgia.
  • To determine the clinical phases of chronic HBV infection within the Georgian population.

Main Methods:

  • A cohort of 111 chronic HBV-infected patients was randomly selected.
  • Liver fibrosis was assessed using Fibroscan.
  • Viral load was quantified via Real-Time Polymerase Chain Reaction (PCR).

Main Results:

  • Of 74 patients with fibrosis data, 97% showed no advanced fibrosis.
  • Of 94 patients with viral load data, 74.5% had HBV-DNA < 2000 IU/ml.
  • Clinical phase assessment was possible for 54% of patients; 75% had viral load < 2000 IU/ml, indicating infection without hepatitis for most.
  • However, 19% of patients fell into an indeterminate category, and 18.5% had HBV-DNA > 2000 IU/ml with normal ALT.

Conclusions:

  • The majority of chronic HBV patients in Georgia appear to have infection without active hepatitis, characterized by low viral loads and minimal fibrosis.
  • A significant proportion (19%) of patients could not be classified into standard clinical phases, highlighting a need for cautious evaluation and individualized management.
  • Further research is warranted to understand high viral loads in HBeAg-negative patients with normal ALT and their long-term outcomes, including fibrosis and hepatocellular carcinoma (HCC) development.