Characteristics of an Outpatient Cohort with HBeAg-Negative Chronic Hepatitis B

Overview

Journal Open Access Maced J Med Sci

Specialty General Medicine

Date 2019 Aug 29

PMID 31456827

Authors

Marija Dimzova

Mile Bosilkovski

Irena Kondova-Topuzovska

Magdalena Gaseva

Boban Toshevki

Biljana Petreska

Dejan Jakimovski

Affiliations

Soon will be listed here.

Abstract

Background: Patients with hepatitis Be antigen-negative chronic hepatitis B (HBeAg-negative CHB), and patients' inactive carriers (IC) have similar laboratory and serologic characteristics and are not always easy to distinguish.

Aim: To characterise hepatitis Be antigen (HBeAg) negative chronic hepatitis B cohort based on their laboratory and virology evaluations at one point of time.

Methods: A prospective non-randomized study was conducted on 109 patients with HBeAg negative chronic hepatitis B treated as outpatients at the Clinic for Infectious Diseases and Febrile Conditions. All patients underwent laboratory and serology testing, quantification of HBV DNA and HBs antigen (qHBsAg).

Results: A group of 56 patients were inactive carriers (IC), and 53 patients had HBeAg-negative CHB (AH). The mean values of ALT, HBV DNA and qHBsAg in IC were 29.13 U/L; 727.95 IU/ml and 2753.73 IU/ml respectively. In the AH group, the mean values of ALT, HBV DNA and quantitative HBsAg were 50.45 U/L; 7237363.98 IU/ml and 12556.06 IU/ml respectively. The serum value of ALT was more influenced by qHBsAg than HBV DNA in both IC and AH groups (R = 0.22 vs R = 0.15) (p > 0.05).

Conclusion: patients with inactive and active HBeAg-negative CHB have similar laboratory and serology profile. It is necessary to combine analysis of ALT, HBV DNA and qHBsAg for better discrimination between patient's IC and patient with HBeAg-negative CHB.

References

Papatheodoridis G, Hadziyannis S . Diagnosis and management of pre-core mutant chronic hepatitis B. J Viral Hepat. 2001; 8(5):311-21. DOI: 10.1046/j.1365-2893.2001.00303.x. View

Funk M, Rosenberg D, Lok A . World-wide epidemiology of HBeAg-negative chronic hepatitis B and associated precore and core promoter variants. J Viral Hepat. 2002; 9(1):52-61. DOI: 10.1046/j.1365-2893.2002.00304.x. View

Chu C, Hussain M, Lok A . Quantitative serum HBV DNA levels during different stages of chronic hepatitis B infection. Hepatology. 2002; 36(6):1408-15. DOI: 10.1053/jhep.2002.36949. View

Manesis E, Papatheodoridis G, Sevastianos V, Cholongitas E, Papaioannou C, Hadziyannis S . Significance of hepatitis B viremia levels determined by a quantitative polymerase chain reaction assay in patients with hepatitis B e antigen-negative chronic hepatitis B virus infection. Am J Gastroenterol. 2003; 98(10):2261-7. DOI: 10.1111/j.1572-0241.2003.07715.x. View

Bosch F, Ribes J, Cleries R, Diaz M . Epidemiology of hepatocellular carcinoma. Clin Liver Dis. 2005; 9(2):191-211, v. DOI: 10.1016/j.cld.2004.12.009. View

Hadziyannis S, Papatheodoridis G . Hepatitis B e antigen-negative chronic hepatitis B: natural history and treatment. Semin Liver Dis. 2006; 26(2):130-41. DOI: 10.1055/s-2006-939751. View

Fattovich G, Olivari N, Pasino M, DOnofrio M, Martone E, Donato F . Long-term outcome of chronic hepatitis B in Caucasian patients: mortality after 25 years. Gut. 2007; 57(1):84-90. DOI: 10.1136/gut.2007.128496. View

Chen C, Iloeje U, Yang H . Long-term outcomes in hepatitis B: the REVEAL-HBV study. Clin Liver Dis. 2007; 11(4):797-816, viii. DOI: 10.1016/j.cld.2007.08.005. View

Fattovich G, Bortolotti F, Donato F . Natural history of chronic hepatitis B: special emphasis on disease progression and prognostic factors. J Hepatol. 2007; 48(2):335-52. DOI: 10.1016/j.jhep.2007.11.011. View

10.

Kumar M, Sarin S, Hissar S, Pande C, Sakhuja P, Sharma B . Virologic and histologic features of chronic hepatitis B virus-infected asymptomatic patients with persistently normal ALT. Gastroenterology. 2008; 134(5):1376-84. DOI: 10.1053/j.gastro.2008.02.075. View

11.

Zacharakis G, Koskinas J, Kotsiou S, Tzara F, Vafeiadis N, Papoutselis M . The role of serial measurement of serum HBV DNA levels in patients with chronic HBeAg(-) hepatitis B infection: association with liver disease progression. A prospective cohort study. J Hepatol. 2008; 49(6):884-91. DOI: 10.1016/j.jhep.2008.06.009. View

12.

Madan K, Batra Y, Jha J, Kumar S, Kalra N, Paul S . Clinical relevance of HBV DNA load in patients with chronic hepatitis B infection. Trop Gastroenterol. 2008; 29(2):84-90. View

13.

Liaw Y . Natural history of chronic hepatitis B virus infection and long-term outcome under treatment. Liver Int. 2009; 29 Suppl 1:100-7. DOI: 10.1111/j.1478-3231.2008.01941.x. View

14.

Chu C, Liaw Y . Incidence and risk factors of progression to cirrhosis in inactive carriers of hepatitis B virus. Am J Gastroenterol. 2009; 104(7):1693-9. DOI: 10.1038/ajg.2009.187. View

15.

Lok A, McMahon B . Chronic hepatitis B: update 2009. Hepatology. 2009; 50(3):661-2. DOI: 10.1002/hep.23190. View

16.

Chen Y, Chu C, Liaw Y . Age-specific prognosis following spontaneous hepatitis B e antigen seroconversion in chronic hepatitis B. Hepatology. 2009; 51(2):435-44. DOI: 10.1002/hep.23348. View

17.

McMahon B . Natural history of chronic hepatitis B. Clin Liver Dis. 2010; 14(3):381-96. DOI: 10.1016/j.cld.2010.05.007. View

18.

Tong M, Hsu L, Hsien C, Kao J, Durazo F, Saab S . A comparison of hepatitis B viral markers of patients in different clinical stages of chronic infection. Hepatol Int. 2010; 4(2):516-22. PMC: 2896649. DOI: 10.1007/s12072-010-9179-1. View

19.

Chen C, Yang H . Natural history of chronic hepatitis B REVEALed. J Gastroenterol Hepatol. 2011; 26(4):628-38. DOI: 10.1111/j.1440-1746.2011.06695.x. View

20.

Ijaz B, Ahmad W, Javed F, Gull S, Hassan S . Revised cutoff values of ALT and HBV DNA level can better differentiate HBeAg (-) chronic inactive HBV patients from active carriers. Virol J. 2011; 8:86. PMC: 3052190. DOI: 10.1186/1743-422X-8-86. View