Significant hepatic histopathology in chronic hepatitis B patients with serum ALT less than twice ULN and high HBV-DNA levels in Indonesia

C. Rinaldi Lesmana, Rino A. Gani, Irsan Hasan, Marcellus Simadibrata, Ali Sulaiman, Levina S. Pakasi, Unggul Budihusodo, Ening Krisnuhoni, Laurentius M. Adrianto Lesmana

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15 Citations (Scopus)

Abstract

OBJECTIVE: To study the prevalence of significant hepatic histopathology in chronic hepatitis B (CHB) patients with alanine aminotransferase (ALT)≤twice upper limit of normal (ULN) and its association with age, HBeAg status, hepatitis B virus (HBV)-DNA level and viral genotype. METHODS: A prospective study was conducted over a 3-year period in treatment-naive CHB patients with ALT≤twice ULN. Patients with a history of acute flare hepatitis, use of alcohol and hepatotoxic drugs, hepatitis C, hepatitis D and human immunodeficiency virus (HIV) co-infection were excluded from the study. Hepatic histopathology was assessed according to the METAVIR scoring system. RESULTS: A total of 145 patients were recruited, 81 (55.9%) of whom were male. The patients' mean age was 41.50±10.74 years (range 16-70 years). Significant hepatic inflammation was found in 59.3% of these patients, and significant hepatic fibrosis was found in 62.1%, the latter being associated with hepatitis B e antigen status, ALT levels and serum HBV-DNA, but not with their age group or viral genotype. Significant hepatic fibrosis was found in 24 of 35 CHB patients (68.6%) who were previously considered in an immunotolerance phase. CONCLUSIONS The prevalence of significant hepatic histopathology in CHB patients with serum ALT levels≤twice ULN is high. Delayed antiviral treatment can be harmful.

Original languageEnglish
Pages (from-to)476-480
Number of pages5
JournalJournal of Digestive Diseases
Volume12
Issue number6
DOIs
Publication statusPublished - Dec 2011

Keywords

  • Chronic hepatitis B
  • Normal alanine aminotransferase
  • Significant liver histopathology

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