Evaluation of serum HBV viral load, transaminases and histological features in chronic HBeAg-negative hepatitis B patients.
OBJECTIVE
To evaluate the association between biochemical, virologic and histologic features in patients with HBeAg-negative chronic hepatitis B (CHB).


BACKGROUND
Hepatitis-B e-antigen (HBeAg)-negative is common in Iran, is progressive with poor prognosis. Therefore, it seems necessary to perform a comprehensive evaluation of different spectrum of laboratory measurements accompanying histological findings.


METHODS
HBeAg- negative CHB patients referring to two university hospitals during two years were enrolled. Alcohol consumption, liver mass, fatty liver and positive results of Anti HDV, Anti HCV or Anti HIV were excluded. The relationship between viral loads, liver enzymes (old and new cutoffs) and histopathological features was analyzed using descriptive and analytic statistical methods.


RESULTS
A total of 150 HBeAg-negative CHB (males=110, mean age=38.44±11.34 years) were assessed. ALT had a significant relation with the logarithm of serum HBV-DNA (P<0.0001), grade and stage on liver biopsy (P<0.001, P=0.034, respectively). Serum viral load, AST and ALT were independent predictors of histological grade, age was the only independent predictor of the stage of liver fibrosis. There was a significant relationship between serum ALT and stage of liver fibrosis (P<0.0001) when new cutoff values for ALT were considered. We found that age had a significant relation with histological grade but it showed a reverse relation with ALT levels (P=0.009).


CONCLUSIONS
In HBeAg-negative CHB, AST had a better prediction for liver necrosis and inflammation. Age could be an independent predictor for liver fibrosis. New cutoff values for ALT had superiority over conventional values to identify higher risk of liver fibrosis.
Internal Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abbas
A
Esmaeelzadeh
Internal Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Hassan
H
Saadatnia
Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Bahram
B
Memar
Department of internal medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
Elham
E
Mokhtari Amirmajdi
Internal Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Azita
A
Ganji
Internal Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Ladan
L
Goshayeshi
Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Zahra
Z
Meshkat
Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Alireza
A
Pasdar
Internal Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Hassan
H
Vosoughinia
Internal Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohammadreza
M
Farzanehfar
Clinical Research Development Center, Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Shahrzad
S
Tehranian
Anatomoclinical Pathologist, Razavi hospital, Mashhad, Iran.
Kamran
K
Ghaffarzadehgan
Department of Radiology, Faculty of Medicine, Islamic Azad University-Mashhad Branch, Mashhad, Iran.
Farnood
F
Rajabzadeh
Internal Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mitra
M
Ahadi
ALT; AST; HBeAg-negative; grade; stage; viral load