TITLE

Significance of HBV DNA Levels in Liver Histology of HBeAg and Anti-HBe Positive Patients with Chronic Hepatitis B

AUTHOR(S)
Man-Fung Yuen; Irene Oi-Lin Ng; Sheung-Tat Fan; He-Jun Yuan; Danny Ka-Ho Wong; John Chi-Hang Yuen; Simon Siu-Man Sum; Annie On-On Chan; Ching-Lung Lai
PUB. DATE
October 2004
SOURCE
American Journal of Gastroenterology;Oct2004, Vol. 99 Issue 10, p2032
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVE: To determine the relationship between hepatitis B virus (HBV) DNA levels and total histologic activity index (HAI), necroinflammation (HAI-NI), and fibrosis (HAI-F) scores.PATIENTS AND METHODS: Liver histology and HBV DNA levels were determined in 94 patients with chronic hepatitis B.RESULTS: There was no association between HBV DNA levels and liver histology in hepatitis-B-e antigen-positive patients (n= 43). In anti-HBe-positive patients (n= 51), HBV DNA levels correlated positively with HAI-NI (r= 0.31,p= 0.014) and HAI-F (r= 0.33,p= 0.017) scores. Though the majority of anti-HBe-positive patients with HBV DNA levels<105 copies/ml had mild necroinflammation and no fibrosis, 14.3% had established fibrosis. Anti-HBe-positive patients with core promoter mutations had a poorer histology compared to those without. There was no difference in the histology between anti-HBe-positive patients with and without precore mutations. Alanine aminotransferase (ALT) level correlated positively with HAI-NI score. Patients with persistently normal ALT levels had a significantly lower median HAI-NI score compared to patients with either persistently or intermittently elevated ALT levels.CONCLUSIONS: In anti-HBe-positive patients, though HBV DNA level<105 copies/ml was associated with better histology, 14.3% patients had established fibrosis. Further studies to define a better cut-off HBV DNA level to differentiate low- and high-risk patients for disease progression are required.
ACCESSION #
14816480

 

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