Virologic and Histologic Features of Chronic Hepatitis B Virus-Infected Asymptomatic Patients With Persistently Normal ALT

Kumar, Manoj; Sarin, Shiv Kumar; Hissar, Syed; Pande, Chandana; Sakhuja, Puja; Sharma, Barjesh Chander; Chauhan, Richa; Bose, Sujoy

doi:10.1053/j.gastro.2008.02.075

Cited by 364 publications

(405 citation statements)

References 42 publications

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“…Similar findings of histological progression in the presence of normal serum ALT levels and low levels of viremia have been previously reported [38,45].…”

Section: Discussionsupporting

confidence: 88%

Chronic hepatitis B infection in a hepatology clinic at a university hospital in Jeddah

Fallatah

Akbar

2010

J Infect Dev Ctries

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Introduction: The outcome of chronic hepatitis B (CHB) infection in a cohort of CHB patients at the hepatology clinics of King Abdul Aziz University Hospital in Jeddah was studied. Methodology: The results of a complete blood count, prothrombin time, liver function test and hepatitis B virus polymerase chain reaction (HBV-PCR) performed over the previous two to five years of follow-up were reviewed. Results of abdominal ultrasound performed within the last year and the data on the treatment type, duration and resistance were also obtained. Results: The majority of the 109 patients studied were Hepatitis B e antigen (HBeAg-negative; 87.2%). Male patients had higher serum ALT values compared to females at follow-up. HBeAg-positive patients had higher HBV-PCR levels at diagnosis compared to HBeAgnegative patients. Patients below 40 years of age had higher HBV-PCR compared to those above 40 years. Ultrasound showed liver cirrhosis in 11% of patients. Cirrhotic patients had higher GGT levels compared to non cirrhotic patients. Drug resistance developed in 25% of the 20 Lamivudine-treated patients. The mean duration of treatment was 2.5 ± .47 years. Conclusion: CHB was predominantly HBeAg negative, with a benign long-term outcome in most patients. Therapy may need to be individualized for patients with high risk of progression.

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“…Similar findings of histological progression in the presence of normal serum ALT levels and low levels of viremia have been previously reported [38,45].…”

Section: Discussionsupporting

confidence: 88%

Chronic hepatitis B infection in a hepatology clinic at a university hospital in Jeddah

Fallatah

Akbar

2010

J Infect Dev Ctries

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“…A pproximately 400 million people are chronically infected with hepatitis B virus (HBV) worldwide, 1 and almost half have acquired their infections either through mother to infant transmission or in early childhood, especially in countries where HBV has intermediate to high prevalence. 2 In Asia, 8%-10% of the population is chronically infected with HBV, and up to 50% of new cases of hepatitis B infection are due to mother to infant transmission.…”

mentioning

confidence: 99%

Chronic Hepatitis B Virus Infection and Pregnancy

Kumar

Singh

Sinha

2012

Journal of Clinical and Experimental Hepatology

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Planning of pregnancy and management of chronic hepatitis B virus during pregnancy includes recognition of maternal virological status, assessment of liver disease severity and minimization of risk for mother to infant transmission of infection. Decisions regarding the use of antivirals during pregnancy need to be individualized. Monitoring for infection and immunization in newborns is also important. For mothers on antiviral therapy, breastfeeding is not recommended. ( J CLIN EXP HEPATOL 2012;2:366-381) A pproximately 400 million people are chronically infected with hepatitis B virus (HBV) worldwide, 1 and almost half have acquired their infections either through mother to infant transmission or in early childhood, especially in countries where HBV has intermediate to high prevalence.2 In Asia, 8%-10% of the population is chronically infected with HBV, and up to 50% of new cases of hepatitis B infection are due to mother to infant transmission.3 In contrast, the majority of new hepatitis B cases in developed countries are the result of horizontal transmission in adulthood. Before the adoption of standard passive-active immunoprophylaxis treatment, approximately 70%-90% of infants born to hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) positive mothers became chronically infected with HBV. 4 The mother to infant transmission rate was reduced to 5%-10% when infants received appropriate postnatal hepatitis B immunoglobulin (HBIg) and a series of HBV vaccines. However, despite passive-active immunoprophylaxis provided to infants, up to 8%-30% of infants born to highly viremic mothers still become infected with HBV (Figures 1-3). This review will address several issues important to chronic hepatitis B virus infection and pregnancy including effect of pregnancy on chronic HBV infection, effect of chronic HBV infection on pregnancy, mother to infant transmission, safety data on HBV antivirals during pregnancy, management of chronic HBV infection in women who desire pregnancy or become pregnant while taking antivirals. PREVALENCE OF CHRONIC HEPATITIS B VIRUS INFECTION AMONG PREGNANT WOMEN IN INDIAThe prevalence of chronic HBV infection varies widely, with rates ranging from 0.1% to 20% in different parts of the world.2 "High" prevalence (HBsAg positivity rates > 8%) regions include the Asia (except Japan), parts of the Middle East, sub-Saharan Africa, and the Amazon basin. "Intermediate" (2%-7% HBsAg positive) prevalence regions include, the Indian subcontinent, parts of central Asia and the Middle East, Eastern and Southern Europe, as well as parts of South America. "Low" prevalence (<2% HBsAg positive) regions include the United States, Northern Europe, Australia, Japan and the southern part of South America. Overall, 45% of the world population lives in "high" prevalence regions.The HBsAg positivity rate of Hepatitis B in India is different in the different regions of the country. The overall chronic HBsAg positivity rate is often quoted as being 4.7%.5 In India, the prevalence rate of HBsAg...

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“…Kod 12 asimptomatskih pacijenata nakon otkrivanja povišenih transaminaza u toku rutinskih laboratorijskih analiza i fizikalnih pregleda definitivna dijagnoza je postavljena nakon nalaza HBsAg u serumu dobrovoljnih davalaca krvi. U našem radu kod asimptomatskih ispitanika sa perzistentno povišenim nivoom ALT češće je evidentiran teži oblik oštećenja jetre [11].…”

Section: Diskusijaunclassified

Comparison of clinical, biochemical and morphological parameters in patients with chronic hepatitis B

Nickovic¹,

Odalovic²,

Aritonovic³

et al. 2017

Praxis Med

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1 Kliničko-bolnički centar Gračanica, Laplje selo, Srbija 2 Univerzitet u Prištini, Medicinski fakultet, Kosovska Mitrovica, Srbija Uvod. Hepatitis B virus je primarno hepatotropni virus, koji je kod 5-10% bolesnika izazivač hroničnog hepatitisa B. Hronična hepatitis B infekcija je dinamičan proces, koji može da ima pet faza: imunotolerantnu, imunoaktivnu, fazu latence, reaktivnu i HBsAg negativnu fazu. Cilj rada. Ispitivanje veze kliničkih i biohemijskih parametara pacijenata sa morfološkim stanjem jetre. Metode rada. Istraživanje je obuhvatilo 35 pacijenata sa dijagnozom HHB, 24 muškog i 11 ženskog pola, starosti 12-62 godine, u periodu 2015-2016. godine. Dijagnoza je postavljena na osnovu seroloških, biohemijskih rezultata, kao i biopsije jetre. Kod pacijenata je ELISA testom dokazano prisustvo HBsAg u serumu. Rezultati. Studija pokazuje da od hronične hepatitis B infekcije češće oboljevaju osobe muškog pola, srednje starosne dobi. Najveći broj pacijenata ima jedan ili dva simptoma. Malaksalost i bol ispod desnog rebarnog luka su najučestaliji u grupama sa drugim i trećim stepenom fibroze, a hepatomegalija u grupi sa prvim stepenom. Splenomegalija je prisutna samo u grupama sa trećim i četvrtim stepenom fibroze. Nivo aminotransaminaza je rastao sa nekrozom hepatocita i stpenom fibroze. Značajna statistička razlika nivoa aminotransaminaza potvrđena je između pacijenata treće i četvrte grupe i pacijenata bez fibroze. Zaključak. Česta diskrepanca kliničke slike i labaratorijskih nalaza, daje na značaju biopsiji kao ,,zlatnom standardu" u postavljanju dijagnoze, određivanju faze HHB, proceni lečenja, praćenju toka bolesti i prognozi bolesti. Zbog toka infekcije i njenih ozbiljnih komlikacija, treba raditi na prevenciji i eradikaciji hepatitis B virusne infekcije, obaveznom imunizacijom svih nevakcinisanih i nepotpuno vakcinisanih osoba.Ključne reči: Hronični hepatitis B, kliničke karakteristike, ALT, biopsija jetre. UVODHepatitis B virus je primarno hepatotropni virus, koji je izazivač kako akutnog, tako i hroničnog hepatitisa B (HHB). Primarna hepatitis B virusna (HBV) infekcija je najčešće samoogaraničavajuća bolest, sa kompletnim izlečenjem za 2-3 meseca. Međutim, kod 5-10% pacijenata primarna HBV infekcija može da pređe u perzistentnu (hroničnu) infekciju [1].Prema podacima Svetske zdravstvene organizacije (SZO) kod oko 400 miliona ljudi (5% populacije) razvila se hronična infekcija. Hronična HBV infekcija je dinamičan proces, koji može da ima pet faza: imunotolerantnu, imunoaktivnu, fazu latence, reaktivnu i HBs antigen (HBsAg) negativnu fazu. Imunotolerantna faza se karakteriše prisustvom HBeAg u serumu, visokim nivoom viremije (HBV DNA u krvi), normalnim ili niskim nivom aminotransferaza i minimalnim nekroinflamatornim promenama u jetri. Ova faza može da traje od nekoliko nedelja do 2-3 decenije. Imunoaktivna faza se karakteriše skokom viremije, tj. nivoa HBV DNA, naglim porastom ALT (> 5 puta) i izraženim nekroinflamatornim ošte-ćenjem jetre. Nakon pika HBV DNA u krvi, nivo viremije je značajno snižen, a ...

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Virologic and Histologic Features of Chronic Hepatitis B Virus-Infected Asymptomatic Patients With Persistently Normal ALT

Cited by 364 publications

References 42 publications

Chronic hepatitis B infection in a hepatology clinic at a university hospital in Jeddah

Chronic hepatitis B infection in a hepatology clinic at a university hospital in Jeddah

Chronic Hepatitis B Virus Infection and Pregnancy

Comparison of clinical, biochemical and morphological parameters in patients with chronic hepatitis B

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