Characteristics of an outpatient chronic hepatitis B virus infection cohort

Abstract

Objective:To characterize a chronic hepatitis B cohort based on initial and follow-up clinical evaluations.Methods:A retrospective and descriptive analysis of clinical and laboratory data from chronic HBsAg adult carriers, without HIV, unexposed to treatment, with at least two outpatient visits, between February 2006 and November 2012. Fisher´s exact test, χ², Wilcoxon, Spearman, multiple comparisons and Kappa tests were applied, the level of significance adopted was 5%, with a 95% confidence interval.Results:175 patients with mean age of 42.95±12.53 years were included: 93 (53.1%) were men, 152 (86.9%) were negative for hepatitis B e-antigen (HBeAg), 3 (1.7%) had hepatitis C coinfection, 15 (8.6%) had cirrhosis, and 2 (1.1%) had hepatocellular carcinoma. Genotype A predominated. Sixty-six patients (37.7%) had active hepatitis, 6 (3.4%) presented immune tolerance, and 38 (21.7%) were inactive carriers. Exacerbations and/or viral breakthrough were detected in 16 patients (9.1%). In 32 patients (18.3%), hepatitis B virus DNA remained persistently elevated and alanine aminotransferase levels were normal, whereas in 17 (9.7%), there was low hepatitis B virus DNA and alterated alanine aminotransferase. If only initial alanine aminotransferase and hepatitis B virus DNA values were considered, 15 cases of active hepatitis would not have been detected. Advanced fibrosis was more common in HBeAg-positive patients, and it was significantly associated with transaminases, hepatitis B virus DNA, and age.Conclusion:Many patients had active hepatitis, but almost 25%, who were HBeAg non-reactive, were only identified because of combined analyses of the hepatitis B virus DNA and transaminases levels, sometimes associated with histological data, after clinical follow-up.

Clinicopathological Characteristics of a Group of Sub-Saharan African Patients with Chronic Hepatitis B Infection: A Gender Analysis

“…In Cameroon, a 2014 study on liver cancer found that there was male predominance, but, in multivariate analysis, gender did not turn out as a risk factor for HCC [9]. Overall, in this study, liver cancer was found in 6.3% of patients, which is significantly higher than the findings of a study conducted in Brazil in 2014, which found liver cancer in 1.1% of patients [10]. Conversely, in this same study conducted in Brazil, 8.6% [10] of patients had cirrhosis, which is close to the 7% found in Cameroon.…”

“…Overall, in this study, liver cancer was found in 6.3% of patients, which is significantly higher than the findings of a study conducted in Brazil in 2014, which found liver cancer in 1.1% of patients [10]. Conversely, in this same study conducted in Brazil, 8.6% [10] of patients had cirrhosis, which is close to the 7% found in Cameroon. These results can be explained by the respect of the monitoring of patients with cirrhosis in the context of liver cancer screening [7].…”

“…According to the literature reviewed, the latter gender is the main carrier of the hepatitis B virus [4,5,[10][11][12]. This is delicate because the male gender has been found to have a higher risk of developing complications such as cirrhosis and HCC [2,8,13,14].…”

“…The anti-HBe was predominant in the literature reviewed at a rate of close to 90% as compared to its antigen [10]. The natural history of HBV in the first two phases (immune tolerance and immune response) is characterized by the presence of HBeAg positive, then HBeAg loss in the inactive carrier phase and appearance of anti-HBe [2,3,7].…”

Treatment of Chronic Hepatitis B With Tenofovir At The University Teaching Hospital Campus of Lome (Togo)

“…The systematic research of HBV in routine could help to reduce cases of dangerous complications like cirrhosis or hepatocellular carcinoma. The majority (89.3%) of our patients was HBeAg negative as in most of European studies [13,14]. This high prevalence of the negative HBeAg is the current world wide trend [15] apart from Asia where there is still high prevalences of HBeAg positive [12].…”