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Published on: February 19, 2019
Study on liver histopathology of chronic HBV infected patients with different normal ALT values
Zhan Zeng1,2, Hongxiao Hao1, Xiaoyue Bi1
1Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Insights
This study found that alanine aminotransferase (ALT) normal values did not significantly differ in detecting significant liver inflammation or fibrosis in chronic hepatitis B (CHB) patients. ALT, hepatitis B surface antigen (HBsAg), and hepatitis B e antigen (HBeAg) status are key factors.
Area of Science:
- Hepatology
- Virology
- Pathology
Background:
- Chronic hepatitis B (CHB) poses a significant global health challenge, necessitating accurate methods for assessing liver inflammation and fibrosis.
- Alanine aminotransferase (ALT) levels are commonly used as a marker for liver injury, but their interpretation can vary based on differing normal value criteria.
- Histopathological examination remains the gold standard for evaluating liver damage in CHB patients.
Purpose of the Study:
- To compare the diagnostic accuracy of different alanine aminotransferase (ALT) normal values in identifying significant liver inflammation and fibrosis in patients with chronic hepatitis B (CHB).
- To investigate the correlation between ALT levels, hepatitis B surface antigen (HBsAg), and hepatitis B e antigen (HBeAg) status with histopathological findings in CHB patients.
Main Methods:
- Retrospective enrollment of 1474 CHB patients diagnosed via liver histopathology between May 2008 and November 2020.
- Analysis of significant hepatic histopathology (inflammation grade G > 1 and/or fibrosis stage S > 1) based on different ALT normal value criteria (AASLD vs. Chinese guidelines).
- Logistic regression analysis to identify factors associated with significant hepatic histopathology, including ALT, HBsAg, and HBeAg status.
Main Results:
- No statistically significant difference was observed in the prevalence of significant hepatic histopathology between normal and abnormal ALT values using either AASLD or Chinese guideline criteria.
- ALT, HBsAg, and HBeAg status were identified as significant factors associated with the occurrence of significant hepatic histopathology (P < 0.001).
- ALT showed a positive correlation with inflammation grade (r = 0.194, P < 0.001) and a negative correlation with fibrosis stage (r = -0.066, P = 0.021).
Conclusions:
- The study concludes that differing ALT normal value criteria do not significantly impact the detection of significant liver histopathology in CHB patients.
- ALT, HBsAg, and HBeAg status are crucial indicators related to the presence of significant liver histopathology in CHB.
- These findings highlight the importance of considering viral markers alongside ALT levels for a comprehensive assessment of liver health in CHB management.
Aims:
Comparison of liver histopathological findings to explore the occurrence of liver inflammation in patients with chronic hepatitis B (CHB) under different alanine aminotransferase (ALT) normal values.
Methods:
The patients who were diagnosed as chronic hepatitis B virus (HBV) infection by liver histopathology at the Department of Pathology, Beijing Ditan Hospital due to clinical difficulty in defining the degree of liver inflammation or fibrosis were retrospectively enrolled from May 2008 to November 2020. Study of the incidence of significant hepatic histopathology in enrolled patients according to different ALT normal values. Using logistic regression to investigate the relevant factors of significant hepatic histopathology.
Results:
A total of 1474 patients were enrolled, 56.20% of the patients were male, and the overall patients' age was 36.80 ± 10.60 years. 39.00% of patients had liver inflammation grade G > 1, 34.70% liver fibrosis stage S > 1, and 48.17% patients had significant hepatic histopathology (G > 1 and/or S > 1). Among patients with normal ALT values, 36.40% and 40.40% had significant hepatic histopathology by American Association for the Study of Liver Diseases (AASLD) criteria and Chinese guideline criteria, respectively, but the difference was not statistically significant (χ 3.38, P =0.066). In contrast, among patients with abnormal ALT values, 58.90% and 62.20% of patients had significant hepatic histopathology by AASLD criteria and Chinese guideline criteria, respectively, with no significant difference (χ 2.28, P =0.131). ALT (P <0.001, OR=1.019), hepatitis B surface antigen (HBsAg) (P <0.001, OR=0.665) and hepatitis B e antigen (HBeAg) status (P <0.001, OR=2.238) were relevant factors in the occurrence of significant hepatic histopathology. ALT was positively corelated with grade of inflammation G (r =0.194, P <0.001) and negatively correlated with liver fibrosis stage S (r =-0.066, P =0.021).
Conclusions:
Our study found no statistically significant differences in the presence of significant hepatic histopathology under the two ALT criteria. ALT, HBsAg and HBeAg status were related to the occurrence of significant hepatic histopathology.
