Significant hepatic histopathology in chronic hepatitis B patients with serum ALT less than twice ULN and high HBV-DNA levels in Indonesia
OBJECTIVE: To study the prevalence of significant hepatic histopathology in chronic hepatitis B (CHB) patients with alanine aminotransferase (ALT) ≤ twice upper limit of normal (ULN) and its association with age, HBeAg status, hepatitis B virus (HBV)‐DNA level and viral genotype. METHODS: A prospe...
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| Veröffentlicht in: | Journal of digestive diseases 2011-12, Vol.12 (6), p.476-480 |
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| creator | LESMANA, C. Rinaldi A. GANI, Rino A. HASAN, Irsan SIMADIBRATA, Marcellus SULAIMAN, Andri S. PAKASI, Levina S. BUDIHUSODO, Unggul KRISNUHONI, Ening LESMANA, Laurentius A. |
| description | OBJECTIVE: To study the prevalence of significant hepatic histopathology in chronic hepatitis B (CHB) patients with alanine aminotransferase (ALT) ≤ twice upper limit of normal (ULN) and its association with age, HBeAg status, hepatitis B virus (HBV)‐DNA level and viral genotype.
METHODS: A prospective study was conducted over a 3‐year period in treatment‐naive CHB patients with ALT ≤ twice ULN. Patients with a history of acute flare hepatitis, use of alcohol and hepatotoxic drugs, hepatitis C, hepatitis D and human immunodeficiency virus (HIV) co‐infection were excluded from the study. Hepatic histopathology was assessed according to the METAVIR scoring system.
RESULTS: A total of 145 patients were recruited, 81 (55.9%) of whom were male. The patients’ mean age was 41.50 ± 10.74 years (range 16–70 years). Significant hepatic inflammation was found in 59.3% of these patients, and significant hepatic fibrosis was found in 62.1%, the latter being associated with hepatitis B e antigen status, ALT levels and serum HBV‐DNA, but not with their age group or viral genotype. Significant hepatic fibrosis was found in 24 of 35 CHB patients (68.6%) who were previously considered in an immunotolerance phase.
CONCLUSIONS The prevalence of significant hepatic histopathology in CHB patients with serum ALT levels ≤ twice ULN is high. Delayed antiviral treatment can be harmful. |
| doi_str_mv | 10.1111/j.1751-2980.2011.00540.x |
| format | Article |
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METHODS: A prospective study was conducted over a 3‐year period in treatment‐naive CHB patients with ALT ≤ twice ULN. Patients with a history of acute flare hepatitis, use of alcohol and hepatotoxic drugs, hepatitis C, hepatitis D and human immunodeficiency virus (HIV) co‐infection were excluded from the study. Hepatic histopathology was assessed according to the METAVIR scoring system.
RESULTS: A total of 145 patients were recruited, 81 (55.9%) of whom were male. The patients’ mean age was 41.50 ± 10.74 years (range 16–70 years). Significant hepatic inflammation was found in 59.3% of these patients, and significant hepatic fibrosis was found in 62.1%, the latter being associated with hepatitis B e antigen status, ALT levels and serum HBV‐DNA, but not with their age group or viral genotype. Significant hepatic fibrosis was found in 24 of 35 CHB patients (68.6%) who were previously considered in an immunotolerance phase.
CONCLUSIONS The prevalence of significant hepatic histopathology in CHB patients with serum ALT levels ≤ twice ULN is high. Delayed antiviral treatment can be harmful.</description><identifier>ISSN: 1751-2972</identifier><identifier>EISSN: 1751-2980</identifier><identifier>DOI: 10.1111/j.1751-2980.2011.00540.x</identifier><identifier>PMID: 22118698</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Adolescent ; Adult ; Aged ; Alanine Transaminase - blood ; Biopsy ; chronic hepatitis B ; DNA, Viral - blood ; Female ; Genotype ; Hepatitis B e Antigens - blood ; Hepatitis B virus ; Hepatitis B virus - genetics ; Hepatitis B, Chronic - blood ; Hepatitis B, Chronic - ethnology ; Hepatitis B, Chronic - pathology ; Human immunodeficiency virus ; Humans ; Incidence ; Indonesia ; Liver - pathology ; Liver - virology ; Liver Cirrhosis - blood ; Liver Cirrhosis - ethnology ; Liver Cirrhosis - pathology ; Male ; Middle Aged ; normal alanine aminotransferase ; Prospective Studies ; Retrospective Studies ; Severity of Illness Index ; significant liver histopathology ; Young Adult</subject><ispartof>Journal of digestive diseases, 2011-12, Vol.12 (6), p.476-480</ispartof><rights>2011 The Authors. Journal of Digestive Diseases © 2011 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4880-4b0b09c54147264d1655c7a43394d7e2d8017768afdb3412fa76dae40fdcb4093</citedby><cites>FETCH-LOGICAL-c4880-4b0b09c54147264d1655c7a43394d7e2d8017768afdb3412fa76dae40fdcb4093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1751-2980.2011.00540.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1751-2980.2011.00540.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22118698$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LESMANA, C. Rinaldi A.</creatorcontrib><creatorcontrib>GANI, Rino A.</creatorcontrib><creatorcontrib>HASAN, Irsan</creatorcontrib><creatorcontrib>SIMADIBRATA, Marcellus</creatorcontrib><creatorcontrib>SULAIMAN, Andri S.</creatorcontrib><creatorcontrib>PAKASI, Levina S.</creatorcontrib><creatorcontrib>BUDIHUSODO, Unggul</creatorcontrib><creatorcontrib>KRISNUHONI, Ening</creatorcontrib><creatorcontrib>LESMANA, Laurentius A.</creatorcontrib><title>Significant hepatic histopathology in chronic hepatitis B patients with serum ALT less than twice ULN and high HBV-DNA levels in Indonesia</title><title>Journal of digestive diseases</title><addtitle>J Dig Dis</addtitle><description>OBJECTIVE: To study the prevalence of significant hepatic histopathology in chronic hepatitis B (CHB) patients with alanine aminotransferase (ALT) ≤ twice upper limit of normal (ULN) and its association with age, HBeAg status, hepatitis B virus (HBV)‐DNA level and viral genotype.
METHODS: A prospective study was conducted over a 3‐year period in treatment‐naive CHB patients with ALT ≤ twice ULN. Patients with a history of acute flare hepatitis, use of alcohol and hepatotoxic drugs, hepatitis C, hepatitis D and human immunodeficiency virus (HIV) co‐infection were excluded from the study. Hepatic histopathology was assessed according to the METAVIR scoring system.
RESULTS: A total of 145 patients were recruited, 81 (55.9%) of whom were male. The patients’ mean age was 41.50 ± 10.74 years (range 16–70 years). Significant hepatic inflammation was found in 59.3% of these patients, and significant hepatic fibrosis was found in 62.1%, the latter being associated with hepatitis B e antigen status, ALT levels and serum HBV‐DNA, but not with their age group or viral genotype. Significant hepatic fibrosis was found in 24 of 35 CHB patients (68.6%) who were previously considered in an immunotolerance phase.
CONCLUSIONS The prevalence of significant hepatic histopathology in CHB patients with serum ALT levels ≤ twice ULN is high. Delayed antiviral treatment can be harmful.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Alanine Transaminase - blood</subject><subject>Biopsy</subject><subject>chronic hepatitis B</subject><subject>DNA, Viral - blood</subject><subject>Female</subject><subject>Genotype</subject><subject>Hepatitis B e Antigens - blood</subject><subject>Hepatitis B virus</subject><subject>Hepatitis B virus - genetics</subject><subject>Hepatitis B, Chronic - blood</subject><subject>Hepatitis B, Chronic - ethnology</subject><subject>Hepatitis B, Chronic - pathology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Incidence</subject><subject>Indonesia</subject><subject>Liver - pathology</subject><subject>Liver - virology</subject><subject>Liver Cirrhosis - blood</subject><subject>Liver Cirrhosis - ethnology</subject><subject>Liver Cirrhosis - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>normal alanine aminotransferase</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>significant liver histopathology</subject><subject>Young Adult</subject><issn>1751-2972</issn><issn>1751-2980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1y2yAUhZlMO02a9hUyLLuRAggJNNONY-ev4ziLOu2SQYAsXBk5Asf2K_Spi-LU67DhzNzvnDtzDwAQoxTHd7lMMctxQkqOUoIwThHKKUp3J-DsOPhw1Iycgs_eLyNUMF58AqeEYMyLkp-Bvz_twtnaKukCbMxaBqtgY33oomy6tlvsoXVQNX3nhskrEayHV3BQxgUPtzY00Jt-s4Kj6Ry2xnsYGulg2Fpl4NN0BqXTMXXRwLurX8lkNorQi2n9EH3vdOeMt_IL-FjL1puvb_85eLq5no_vkunj7f14NE0U5RwltEIVKlVOMWWkoBoXea6YpFlWUs0M0Rxhxgoua11lFJNaskJLQ1GtVUVRmZ2Db4fcdd89b4wPYmW9Mm0rnek2XmBEEI9hJYkoP6Cq77zvTS3WvV3Jfh8hMTQhlmI4shgOLoYmxGsTYhetF29bNtXK6KPx_-kj8P0AbG1r9u8OFuPJJIpoTw722JXZHe2y_yMKlrFc_J7dipzTH_MH8iAm2T-4-6X2</recordid><startdate>201112</startdate><enddate>201112</enddate><creator>LESMANA, C. Rinaldi A.</creator><creator>GANI, Rino A.</creator><creator>HASAN, Irsan</creator><creator>SIMADIBRATA, Marcellus</creator><creator>SULAIMAN, Andri S.</creator><creator>PAKASI, Levina S.</creator><creator>BUDIHUSODO, Unggul</creator><creator>KRISNUHONI, Ening</creator><creator>LESMANA, Laurentius A.</creator><general>Blackwell Publishing Asia</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TM</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>201112</creationdate><title>Significant hepatic histopathology in chronic hepatitis B patients with serum ALT less than twice ULN and high HBV-DNA levels in Indonesia</title><author>LESMANA, C. Rinaldi A. ; GANI, Rino A. ; HASAN, Irsan ; SIMADIBRATA, Marcellus ; SULAIMAN, Andri S. ; PAKASI, Levina S. ; BUDIHUSODO, Unggul ; KRISNUHONI, Ening ; LESMANA, Laurentius A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4880-4b0b09c54147264d1655c7a43394d7e2d8017768afdb3412fa76dae40fdcb4093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Alanine Transaminase - blood</topic><topic>Biopsy</topic><topic>chronic hepatitis B</topic><topic>DNA, Viral - blood</topic><topic>Female</topic><topic>Genotype</topic><topic>Hepatitis B e Antigens - blood</topic><topic>Hepatitis B virus</topic><topic>Hepatitis B virus - genetics</topic><topic>Hepatitis B, Chronic - blood</topic><topic>Hepatitis B, Chronic - ethnology</topic><topic>Hepatitis B, Chronic - pathology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Incidence</topic><topic>Indonesia</topic><topic>Liver - pathology</topic><topic>Liver - virology</topic><topic>Liver Cirrhosis - blood</topic><topic>Liver Cirrhosis - ethnology</topic><topic>Liver Cirrhosis - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>normal alanine aminotransferase</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>significant liver histopathology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LESMANA, C. Rinaldi A.</creatorcontrib><creatorcontrib>GANI, Rino A.</creatorcontrib><creatorcontrib>HASAN, Irsan</creatorcontrib><creatorcontrib>SIMADIBRATA, Marcellus</creatorcontrib><creatorcontrib>SULAIMAN, Andri S.</creatorcontrib><creatorcontrib>PAKASI, Levina S.</creatorcontrib><creatorcontrib>BUDIHUSODO, Unggul</creatorcontrib><creatorcontrib>KRISNUHONI, Ening</creatorcontrib><creatorcontrib>LESMANA, Laurentius A.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Journal of digestive diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LESMANA, C. Rinaldi A.</au><au>GANI, Rino A.</au><au>HASAN, Irsan</au><au>SIMADIBRATA, Marcellus</au><au>SULAIMAN, Andri S.</au><au>PAKASI, Levina S.</au><au>BUDIHUSODO, Unggul</au><au>KRISNUHONI, Ening</au><au>LESMANA, Laurentius A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Significant hepatic histopathology in chronic hepatitis B patients with serum ALT less than twice ULN and high HBV-DNA levels in Indonesia</atitle><jtitle>Journal of digestive diseases</jtitle><addtitle>J Dig Dis</addtitle><date>2011-12</date><risdate>2011</risdate><volume>12</volume><issue>6</issue><spage>476</spage><epage>480</epage><pages>476-480</pages><issn>1751-2972</issn><eissn>1751-2980</eissn><abstract>OBJECTIVE: To study the prevalence of significant hepatic histopathology in chronic hepatitis B (CHB) patients with alanine aminotransferase (ALT) ≤ twice upper limit of normal (ULN) and its association with age, HBeAg status, hepatitis B virus (HBV)‐DNA level and viral genotype.
METHODS: A prospective study was conducted over a 3‐year period in treatment‐naive CHB patients with ALT ≤ twice ULN. Patients with a history of acute flare hepatitis, use of alcohol and hepatotoxic drugs, hepatitis C, hepatitis D and human immunodeficiency virus (HIV) co‐infection were excluded from the study. Hepatic histopathology was assessed according to the METAVIR scoring system.
RESULTS: A total of 145 patients were recruited, 81 (55.9%) of whom were male. The patients’ mean age was 41.50 ± 10.74 years (range 16–70 years). Significant hepatic inflammation was found in 59.3% of these patients, and significant hepatic fibrosis was found in 62.1%, the latter being associated with hepatitis B e antigen status, ALT levels and serum HBV‐DNA, but not with their age group or viral genotype. Significant hepatic fibrosis was found in 24 of 35 CHB patients (68.6%) who were previously considered in an immunotolerance phase.
CONCLUSIONS The prevalence of significant hepatic histopathology in CHB patients with serum ALT levels ≤ twice ULN is high. Delayed antiviral treatment can be harmful.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>22118698</pmid><doi>10.1111/j.1751-2980.2011.00540.x</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Alanine Transaminase - blood Biopsy chronic hepatitis B DNA, Viral - blood Female Genotype Hepatitis B e Antigens - blood Hepatitis B virus Hepatitis B virus - genetics Hepatitis B, Chronic - blood Hepatitis B, Chronic - ethnology Hepatitis B, Chronic - pathology Human immunodeficiency virus Humans Incidence Indonesia Liver - pathology Liver - virology Liver Cirrhosis - blood Liver Cirrhosis - ethnology Liver Cirrhosis - pathology Male Middle Aged normal alanine aminotransferase Prospective Studies Retrospective Studies Severity of Illness Index significant liver histopathology Young Adult |
| title | Significant hepatic histopathology in chronic hepatitis B patients with serum ALT less than twice ULN and high HBV-DNA levels in Indonesia |
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