Chronic liver disease and cirrhosis among patients with hepatitis B virus infection in northern Portugal with reference to the viral genotypes

Abstract

International audienceThe prevalence of infection with hepatitis B virus in Portugal is around 1% of the population; 20-30% of those infected typically develop cirrhosis. The study focuses on the epidemiological profile of patients with hepatitis B infection and liver damage, in particular, cirrhosis. Of the 358 individuals that comprised the study, a liver biopsy was performed in 249 to identify the presence of cirrhosis. Cirrhosis was observed in 59 patients (23.7%) The Child-Pugh classification was used to assess the prognosis of cirrhosis: 3 out of the 59 patients were classified as Child-Pugh grade C, the most severe, 17 (28.8%) as grade B and 39 (66.2%) as grade A. Patients classified as grade B were older, drank more and showed higher levels of AST and alkaline phosphatase when compared with individuals classified as grade A. Genotypes A and D were predominant, and no significant differences with respect to genotype distribution were observed. Analysis of the haematological parameters showed that patients classified as Child's grade B had lower levels of Platelets and higher levels of prothrombin time than those classified as Child's grade A. The profile of the patients with cirrhosis, including an extended number of individual characteristics, provides useful information, however, only a prospective study could evaluate definitively if liver disease is influenced by these factors. Future studies would benefit from the analysis of the impact of genotypes on liver disease, particularly genotypes A and D, the most predominant genotypes in northern Portugal

Unexpectedly high proportion of drug users and men having sex with men who develop chronic hepatitis B infection

“…MSM were infected with genotype A and DU with genotype D, but both groups had an equally high rate of developing chronic infections. Mota et al have shown that this also counts for the chronic sequelae of an HBV infection, such as cirrhosis [18].…”

Indication for treatment and severity of disease in treatment-naive patients with chronic hepatitis B virus infection

“…Finally, our data is consistent with a number of previously epidemiological results reported in Germany, confirming the validity of our assessment. 13,23 In conclusion, we found significant rates of advanced and untreated chronic hepatitis B infection in the largest European cohort of treatment-naïve patients. Treatment decisions in our multi-ethnic setting were predominately based on serology including viral DNA PCR results and transaminase levels.…”

“…Using 2017 EASL criteria, we grouped our study sample into three treatment categories (s. 22,23 Nevertheless, our study is unique in that all subjects were treatment naïve and presented for first evaluation of disease activity and liver fibrosis. Our combined findings demonstrate a high burden of preventable morbidity in this population and underscores the need for specialized diagnostics and care.…”

Helicobacter pylori cytotoxin-associated gene A activates tumor necrosis factor-α and interleukin-6 in gastric epithelial cells through P300/CBP-associated factor-mediated nuclear factor-κB p65 acetylation

“…It has been reported that infection induces not only innate immune responses but also adaptive immune responses against microorganisms; however in most cases, this fails to eradicate the microorganisms. By contrast, permanent infection ultimately triggers chronic inflammation and further leads to the damage of the body (42,43). It is well accepted that Helicobacter pylori infection triggers production of various cytokines, including IL-1β, IL-6, IL-8, IL-18, IL-32, TNF-α and IL-6, which are known to have important roles in chronic inflammation and ultimate disease outcome (10,14,(44)(45)(46).…”