ADVANCED LIVER INJURY IN PATIENTS WITH CHRONIC HEPATITIS B AND VIRAL LOAD BELOW 2,000 IU/mL

Oliveira, Valter Oberdan Borges de; Oliveira, Juliana Passos Rocha; França, Eloy Vianey Carvalho de; Brito, Hugo Leite de Farias; Nascimento, Tereza Virgínia Silva Bezerra do; França, Alex Vianey Callado

doi:10.1590/s1678-9946201658065

Cited by 5 publications

(5 citation statements)

References 25 publications

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“…The results of Kim JD [ 5 ] suggested that patients in the late stage of liver cirrhosis (decompensation period) could still have significant inflammation of the portal area even if their serum alanine transaminase was normal or serum viral load was very low (<2000 copies/ml). The Oliveira VO study confirmed that low-load HBV DNA did not indicate that liver injury ceased; instead, the liver cell injury continued [ 24 ]. HBV DNA can still be detected in liver tissues of patients with liver cirrhosis without HBV DNA detection in the serum [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

The relationship between serum hepatitis B virus DNA level and liver histology in patients with chronic HBV infection

et al. 2018

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BackgroundThere is no consensus regarding the relationship between HBV DNA and liver fibrosis, and the relationship between HBV DNA and the degree of liver cirrhosis has not been reported in patients with chronic HBV infection.MethodsFrom January 2011 to December 2016, liver biopsies were performed on 396 patients with chronic hepatitis B and cirrhosis. Assessments of liver fibrosis and cirrhosis were based on the Laennec staging system.ResultsSerum levels of HBV DNA were correlated with fibrosis and cirrhosis (KW = 73.946, P<0.001). Serum HBV DNA level was correlated with mild fibrosis, moderate to severe fibrosis and cirrhosis (P = 0.009, P<0.001, and P<0.001, respectively). The HBeAg-positive group and HBeAg-negative group showed significant differences in HBV DNA levels, and the rates of mild fibrosis, severe fibrosis and cirrhosis were significantly different between these two groups (F = 17.585, P<0.001 and F = 6.017, P = 0.003, respectively). The replication status of the serum HBV DNA affected fibrosis formation as well as cirrhosis (χ2 = 53.76, P<0.001). In the HBeAg-positive group, the sensitivity, specificity and AUC values of HBV DNA as a predictor for mild fibrosis and cirrhosis were 64.3%, 78.94% and 0.818, respectively, and 81.0%, 69.2%, and 0.871, respectively. In the HBeAg-negative group, the sensitivity, specificity and AUC values of HBV DNA for liver sclerosis prediction were 48%, 76.8% and 0.697, respectively.ConclusionsDifferent HBV DNA levels had different effects on the formation of fibrosis and sclerosis in liver tissues. HBV DNA levels can predict mild fibrosis and cirrhosis in liver tissue, which is enhanced in HBeAg-positive patients.

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Section: Discussionmentioning

confidence: 99%

The relationship between serum hepatitis B virus DNA level and liver histology in patients with chronic HBV infection

et al. 2018

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“…Oliveira et al carried out an investigation of the liver injury in patients presenting HBsAg(+) for more than six months, Anti-HBe(+)/HBeAg(-), viral load below 2,000 IU/mL, and serum ALT levels less than twice the upper limit of normality. The results showed that 11/27 (40.7%) patients actually had advanced liver injury (35). Besides, research has shown that almost 44% of HBsAg(-) hepatitis patients have a normal range of ALT during the majority period despite having advanced liver diseases (34).…”

Section: Discussionmentioning

confidence: 99%

Association between Serum Cytokeratin-18 Neoepitope M30 (CK-18 M30) Levels and Chronic Hepatitis B: A Meta-Analysis

Liu

et al. 2018

Hepat Mon

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Background: Cytokeratin-18 Neoepitope M30 (CK-18 M30) has been reported to be associated with chronic HBV infection and severity of liver injury; however, the results of these studies are inconsistent. Objectives: We sought to investigate the association between serum CK-18 M30 levels and the severity of liver injury in chronic hepatitis B (CHB) patients. Methods: A systematic literature search was performed in PubMed, Embase, and Cochrane Library databases for relevant studies published in English up to August 2017. Heterogeneity among individual studies was investigated for summarizing all the studies. The standard mean difference (SMD) and 95% confidence interval (CI) were calculated using a random-effects model or fixed-effects model. Finally, the sensitivity analysis and publication bias were performed to evaluate the accuracy of this meta-analysis. Statistical analysis was conducted using Review Manager 5.3 and Stata 12.0. Results: Five case-control studies were included in the ultimate analysis, recruiting 488 CHB patients, 276 inactive carriers, and 193 healthy controls. The major results of the meta-analysis revealed significantly elevated serum CK-18 M30 levels in chronic HBV infected patients including CHB patients with severe liver injury and inactive HBV carriers when compared to healthy controls (SMD = 1.13, 95% CI: 0.75-1.50, P < 0.001; SMD = 0.63, 95% CI: 0.38-0.89, P < 0.001, respectively). Furthermore, the serum CK-18 M30 levels were significantly higher in CHB patients with severe liver injury than in inactive carriers (SMD =1.29, 95% CI: 0.60-1.98, P < 0.001). The sensitivity and publication bias analysis verified the stability and reliability of our analysis. Conclusions: The elevated serum CK-18 M30 levels could be regarded as a useful non-invasive biomarker for the diagnosis of chronic HBV infection, and were associated with the severity of liver injury in chronic Hepatitis B patients. The serum CK-18 M30 levels could reflect the liver inflammation in inactive carriers, representing the early stage of chronic HBV infection.

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“…In addition, we also compared the TAC and APRI levels according to the ”active” versus ”inactive” HBV carriers, which were divided by an HBV viral DNA load of 2000 IU/mL [ 43 ]. In general, the pathological features of HBV-derived chronic inflammation and hepatofibrosis are distinguished by the HBV DNA viral load, likely activation of DNA amplification, and the severity of liver injury [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

Total Antioxidant Capacity in HBV Carriers, a Promising Biomarker for Evaluating Hepatic Fibrosis: A Pilot Study

Wang

Lee

et al. 2021

Antioxidants

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Oxidative stress plays a pivotal role in the progression of chronic hepatitis B; however, it is unclear whether the status of blood oxidative stress and antioxidant components differs depending on the degree of hepatic fibrosis. To explore the relationship between oxidative stress/antioxidant capacity and the extent of hepatic fibrosis, fifty-four subjects with liver fibrosis (5.5 ≤ liver stiffness measurement (LSM) score ≤ 16.0 kPa) by chronic hepatitis B virus (HBV) were analyzed. From the analysis of eight kinds of serum oxidative stress/antioxidant profiles and liver fibrosis degrees, the level of total antioxidant capacity (TAC) reflected a negative correlation with the severity of hepatic fibrosis (Pearson correlation, r = −0.35, p = 0.01). Moreover, TAC showed higher sensitivity (73.91%) than the aspartate transaminase (AST) to platelet ratio index (APRI, 56.52%) in the receiver operating characteristic (ROC) curves. Interestingly, the TAC level finely reflected the fibrosis degree in inactive carriers (HBV DNA < 2000 IU/mL), while the APRI did in active carriers (HBV DNA > 2000 IU/mL). In conclusion, TAC is a promising biomarker for evaluating the progression of liver fibrosis in patients with HBV, and this finding may indicate the involvement of TAC-composing factors in the pathogenesis of hepatic fibrosis in chronic HBV carriers.

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ADVANCED LIVER INJURY IN PATIENTS WITH CHRONIC HEPATITIS B AND VIRAL LOAD BELOW 2,000 IU/mL

Cited by 5 publications

References 25 publications

The relationship between serum hepatitis B virus DNA level and liver histology in patients with chronic HBV infection

The relationship between serum hepatitis B virus DNA level and liver histology in patients with chronic HBV infection

Association between Serum Cytokeratin-18 Neoepitope M30 (CK-18 M30) Levels and Chronic Hepatitis B: A Meta-Analysis

Total Antioxidant Capacity in HBV Carriers, a Promising Biomarker for Evaluating Hepatic Fibrosis: A Pilot Study

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