title: [Liver histological changes in chronic hepatitis B patients with elevated ALT less than 2 x ULN].
abstract: OBJECTIVE
  To investigate the relevant factors of liver histological changes in chronic hepatitis B (CHB) patients with mildly elevated ALT and to explore the clinical values of these factors on anti-viral treatment.
  
  
  METHODS
  A total of 152 CHB patients with mildly elevated ALT (less than 2 x ULN) who underwent liver biopsy were included in the study. Correlations between routine laboratory markers, liver histological inflammation grade and fibrosis stage were statistically assessed by Spearman correlation analysis, one-way ANOVA, area under the curve (AUC) of the receiver operating characteristic curves (ROC) and Logistic regression statistical analysis.
  
  
  RESULTS
  All patients in the study showed various hepatic histological damages. Among the 152 patients 50 (32.9%) were found with inflammation grade 1 (G1), 42 (27.6%) with G2, 46 (30.3%) with G3 and 14 (9.2%) with G4. 16 patients (10.5%) were found with fibrosis stage 2 (S2), 25 (16.5%) with S3 and 41 (27.0%) with S4. Routine laboratory markers Alb, BPC and WBC were significantly correlated with hepatic histological inflammation grade and fibrosis stage. Marked liver fibrosis and moderate to severe liver damage were significantly higher in patients aged more than 40 years as compared to those less than 40 years of age (P = 0.002, P = 0.010). The regression equation P = 1/[1+e-(9.36250-1625Alb-0.0234BPC)] was established with sensitivity and specificity of 83.3% and 65.0%, respectively.
  
  
  CONCLUSIONS
  67.8% of CHB patients with mildly elevated ALT have significant injury to the liver tissue. CHB patients aged more than 40 years have a significant increase of marked liver fibrosis and moderate to severe liver damage. The regression equation is valuable to predict whether CHB patients need antiviral therapy or not.
authors: Department of Liver Disease, Taizhou Peoples' Hospital, Taizhou Jiangsu Province 225300, China. xianjc09@163.com
authors: Jian-Chun
authors: JC
authors: Xian
authors: Hong-Tao
authors: HT
authors: Xu
authors: Yi-Lin
authors: YL
authors: He
authors: Mei-Long
authors: ML
authors: Shen
authors: Ya-Bao
authors: YB
authors: Chen
authors: Li-Xin
authors: LX
authors: Zhang
authors: Li
authors: L
authors: Xiao
authors: Yang
authors: Y
authors: Li
authors: Li-Bin
authors: LB
authors: Han
authors: Hao
authors: H
authors: Li
authors: Lun-Gen
authors: LG
authors: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism*; D005260:Female; D019694:Hepatitis B, Chronic / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000410:Alanine Transaminase