Revised cutoff values of ALT and HBV DNA level can better differentiate HBeAg (-) chronic inactive HBV patients from active carriers

Ijaz, Bushra; Ahmad, Waqar; Javed, Fouzia T; Gull, Sana; Hassan, Sajida

doi:10.1186/1743-422x-8-86

Cited by 26 publications

(24 citation statements)

References 34 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent study, Kim et al (2011) validated the performance of ALT and HBV DNA, and found that these markers may also be used for discriminating HBeAg (−) active carriers from inactive carriers. In the study by Ijaz et al (2011), HBV DNA load was five times higher in chronic active patients, and a statistically significant positive correlation was found between HBV DNA levels and ALT in HBeAg (−) CHB (r = 0.911, p < 0.05), but no such association was observed for ALT in chronic inactive patients. These studies showed that in HBeAg (−) patients, low HBV DNA levels were associated with less liver damage, although this relationship was not observed in other study (Chan et al 2002).…”

Section: Discussionmentioning

confidence: 90%

Serum Decoy Receptor 3 Is a Useful Predictor for the Active Status of Chronic Hepatitis B in Hepatitis B e Antigen-Negative Patients

Hou

Lou

et al. 2013

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Hepatitis B virus (HBV) infection is a global public health problem, because patients with chronic hepatitis B (CHB) may progress to liver cirrhosis and eventually evolve into hepatocellular carcinoma. Decoy receptor 3 (DcR3) is a soluble receptor of the tumor necrosis factor receptor superfamily, and has been implicated in anti-apoptotic and anti-inflammatory pathways. In this study, we explored the clinical value of serum DcR3 in predicting the active status of CHB in hepatitis B e antigen-negative patients (active HBeAg (−) CHB), which was determined with ELISA. The serum level of DcR3 in active HBeAg (−) CHB patients (1.92 ± 0.68 ng/ml) was higher than that in healthy controls (0.80 ± 0.25 ng/ml, p < 0.0001) and that in inactive status of HBeAg (−) CHB (inactive hepatitis B surface antigen carrier, HBsAg-IaC) patients (0.95 ± 0.26 ng/ml, p < 0.0001). DcR3 level was correlated with HBV DNA level (r = 0.819, p < 0.0001) and alanine transaminase level (ALT, r = 0.704, p < 0.0001) in active HBeAg (−) CHB patients. The area under the Receiver Operating Characteristics curve of DcR3 for detecting the active status of HBeAg (−) CHB patients was 0.914 (95% confidence interval, 0.851-0.977). The optimal cut-off value for DcR3 to predict active HBeAg (−) CHB was 1.22 ng/ml, which had a sensitivity of 87.5% and a specificity of 84.4%. These results suggest that serum DcR3 level may be useful for detecting HBeAg (−) CHB in the active stage, which requires medical treatment.

show abstract

Section: Discussionmentioning

confidence: 90%

Serum Decoy Receptor 3 Is a Useful Predictor for the Active Status of Chronic Hepatitis B in Hepatitis B e Antigen-Negative Patients

Hou

Lou

et al. 2013

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

show abstract

“…The cutoff value for serum ALT levels was 40 IU/L and was 35 IU/L for AST [12]. The upper limit of normal for serum AFP levels was ≤10 µg/L [17].…”

Section: Biochemical Tests; Alanine Aminotransferase (Alt or Sgpt) Anmentioning

confidence: 96%

“…The lower limit of detection was 20 IU/mL and the upper limits of detection was 170000000 IU/mL (the quantitative range of this assay is 1.3-8.2 log IU/mL). The Cobas Amplicor HBV Monitor test (real-time polymerase chain reaction, Roche Diagnostic Systems, COBAS® AmpliPrep® HBV Test, COBAS® TaqMan® 48) was used in this study [12,20,21].…”

Section: Serum Hbv Dna Levelsmentioning

confidence: 99%

“…Histopathological changes that occur with HBV infection include necroinflammatory activity (inflammation and necrosis) and fibrosis, which are correlated with HBeAg, anti-HBe, ALT, and HBV DNA levels [8,11] . The guidelines recommend cutoff values of 40 IU/ml for alanine aminotransferase (ALT) levels and 2000 IU/ml for HBV DNA levels [12,13]. A histologic activity index has been created which uses histological features to determine grade (inflammation) and stage (fibrosis) [8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Associations between HBeAg Status, HBV DNA, ALT Level and Liver Histopathology in Patients with Chronic Hepatitis B

Koyuncuer¹

2014

SJCM

View full text Add to dashboard Cite

Hepatitis B virus (HBV) infection is still a significant healthcare problem all over the world. Between January 2009 and May 2014, a total of 96 patients with chronic hepatitis B (CHB) were enrolled in study. A total of 96 CHB cases were examined. The mean total liver histological activity indices for grade and stage were 6.01±2.46, and 1.6±0.99 and the mean ALT and AST levels were 32.6 ±21.0 IU/L and 25.6 ±11.2 IU/L, respectively. The mean HBV DNA level was 8.9 x106±3.3106 IU/mL. Forty (41.7%) patients had HBV DNA <20 IU/Ml (undetectable) and 14 (14.6%) patients had HBV DNA levels between 21 and 2000 IU/mL. Of the total 96 patients, 100% were HBsAg positive, 88 (91.7%) were HBeAg negative and 8 (8.3%) were HBeAg positive. A significant correlation was found between the HBeAg serostatus, HBV DNA level and the histological activity index necroinflammatory total scores (P= 0.034 and 0.000). We found no correlation between the fibrosis score and HBeAg status (P= 0.451). However, a statistically significant difference was found between HBV DNA levels and stage of fibrosis (P= 0.048). A significant relationship was found between the HBeAg status, HBV DNA level and ALT and AST levels (P= 0.000, 0.000, 0.032, 0.024). The HBeAg status of CHB patients should not affect the treatment response or need for long-term follow-up visits with repeat ALT and HBV DNA levels. However, chronic hepatitis patients who are negative for HBeAg may need different short-term follow-up.

show abstract

“…The presence of advanced fibrosis on noninvasive assessment is an independent predictor of HCC development (7). Although traditional blood tests such as alanine aminotransferase (ALT) levels are useful as measures of disease activity, they have proven poor indicators of liver fibrosis alone (8). Studies in Asia and the United States revealed that 20% to 30% of HBV carriers with persistently normal ALT levels and HBV DNA levels >10 4 copies/mL have stage ≥2 inflammation and stage ≥2 fibrosis on liver biopsy (9).…”

Section: Introductionmentioning

confidence: 99%

Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

Parikh¹,

Ryan²,

Tsochatzis³

2017

Ann. Transl. Med.

View full text Add to dashboard Cite

Chronic hepatitis B virus (HBV) infection is a major cause of liver morbidity and mortality worldwide.While a proportion of the 250 million individuals chronically infected with HBV will not come to significant harm or require therapy, many others risk developing complications of the end-stage liver disease such as decompensated cirrhosis and hepatocellular carcinoma (HCC), without intervention. Due to the complex natural history of HBV infection, patients require an expert assessment to interpret biochemistry, viral serology and appropriately stage the disease, and to initiate monitoring and/or therapy where indicated. The detection and quantification of liver fibrosis is a key factor for disease management and prognostication for an individual with HBV. The reliance on invasive liver biopsy to stage disease is diminishing with the advent of robust non-invasive blood-and imagingbased algorithms which can reliably stage disease in many cases. These tests are now incorporated into International guidelines for HBV management and relied upon daily to inform clinical judgement. Both blood-and imagingbased approaches have advantages over liver biopsy, including minimal risks, lower cost, better patient acceptance and speed of results, while disadvantages include lower diagnostic accuracy in intermediate disease stages and variability with co-existing hepatic inflammation or steatosis. This review outlines the methods of fibrosis assessment in chronic HBV infection and focuses on the most commonly used blood-and imaging-based noninvasive tests, reviewing their diagnostic performance and applicability to patient care.

show abstract

Revised cutoff values of ALT and HBV DNA level can better differentiate HBeAg (-) chronic inactive HBV patients from active carriers

Cited by 26 publications

References 34 publications

Serum Decoy Receptor 3 Is a Useful Predictor for the Active Status of Chronic Hepatitis B in Hepatitis B e Antigen-Negative Patients

Serum Decoy Receptor 3 Is a Useful Predictor for the Active Status of Chronic Hepatitis B in Hepatitis B e Antigen-Negative Patients

Associations between HBeAg Status, HBV DNA, ALT Level and Liver Histopathology in Patients with Chronic Hepatitis B

Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

Contact Info

Product

Resources

About