Virology and histopathology in patients with chronic hbv infection in bulgaria

Abstract

The histopathology of hepatitis B is diverse and reflects the natural history of chronic HBV-infection. Liver biopsy is gold standard for assessment of disease-activity and fibrosis. Treatment-decision is based on the assessment of liver disease severity as well as on patient's age, viral load, and HBeAg status. The relationship between these parameters and liver histopathology is not studied in details. We analysed treatment-naïve patients from single canter: 231 with histologically-proven chronic hepatitis B (CHB) and 104 subjects with clinical, laboratory and ultrasound signs of liver cirrhosis (LC). Viral load and HBV-serology were measured in all cases by real-time PCR and ELISA, respectively. Histological assessment of liver biopsies was performed according to METAVIR. Our results showed that the number of HBeAg-positive patient decreases with the increase of the disease activity from A0 to A3 as well as with the increase of the fibrosis stage from F1 to F4. In HBeAg-positive CHB patients both inflammation and fibrosis were more frequently mild or moderate. Severe disease activity (A3) and advanced fibrosis were observed more frequently in HBeAg-negative subjects. HBeAg-positive patients are younger than HBeAg-negative. Such an age difference exists into all separate subgroups

Epidemiology Pattern, Prevalent Genotype Distribution, Fighting Stigma and Control Options for Hepatitis D in Bulgaria and Other European Countries

“…In Bulgaria, HDV genotyping has only been analysed in a few studies, and HDVgenotype 1 was found to be prevalent, similar to the other neighbouring countries [44]. We conducted an investigation among 12 Bulgarian chronic HDV patients, aged 28 to 62 years, during the period of 2013-2019.…”

“…In 1986, Naoumov and colleagues reported the prevalence of delta infection among 105 HBsAg-positive patients with chronic liver diseases and 42 patients who had died due to fulminant hepatitis B. Delta infection was detected in 8.6% of subjects with chronic HBV infection and 7.1% of patients with fulminant hepatitis [42]. During the period of 1986-1997, Krastev and colleagues found the rate of HDV infection to be 16.1% higher among patients in hepatology clinics, with a high concentration of patients with chronic HBV and HDV infection [44]. In 1998, B. Iliev and colleagues reported that of 1465 HBsAg-positive serum samples, 151 (10.3%) were positive for delta infection.…”

“…The highest percentage of infected heamophiliacs (47.06%) was followed by female prostitutes, patients with acute and chronic hepatitis and polytransfused patients [43]. A study among 1280 HBsAg (+) patients who received antiviral therapy from the National Health Insurance Fund between 2008 and 2013 showed a 3.8% rate of HDV [44]. During the period of 2013-2018, we conducted a sero-epidemiological study among 391 patients with chronic liver diseases at the "St. Marina" University Hospital in Varna city.…”