Histological changes in chinese chronic hepatitis B patients with ALT lower than two times upper limits of normal.
The role of ALT as a predictor of liver injury has been questioned. The aim of this study is to use liver biopsy to assess the degree of liver injury in patients with chronic hepatitis B(CHB) whose ALT < 2 x upper limit of normal (ULN). A total of 49.2% of patients in this study had significant inflammation (grade >or=2) and 36.4% had significant fibrosis (stage >or=2). The frequency of serious inflammation and fibrosis was similar in patients with different ALT levels. The level of serum HBV DNA was not significantly associated with the extent of inflammation and fibrosis. Advanced age was a significant independent predictor of histological damage and the presence of more significant inflammation and fibrosis. We conclude that many CHB patients with ALT < 2 x ULN have significant liver inflammation or fibrosis and that liver biopsy is necessary to assess liver damage and should be used to assess the need for anti-viral therapy.
Chen
En-Qiang
EQ
Center of Infectious Diseases, Division of Molecular Biology of Infectious Diseases, National Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, People's Republic of China.
Huang
Fei-Jun
FJ
He
Ling-Li
LL
Bai
Lang
L
Wang
Li-Chun
LC
Zhou
Tao-You
TY
Lei
Xue-Zhong
XZ
Liu
Cong
C
Tang
Hong
H
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D001706:Biopsy; D002681:China / Q000453:epidemiology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000201:enzymology / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008099:Liver / Q000473:pathology* / Q000821:virology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase