Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/80000
Title: Clinical and histopathological features of chronic hepatitis B virus infected patients with high HBV-DNA viral load and normal alanine aminotransferase level : a multicentre-based study in China
Authors: Xing, YF
Zhou, DQ
He, JS
Wei, CS
Zhong, WC
Han, ZY
Peng, DT
Shao, MM
Sham, TT 
Mok DKW 
Chan CO 
Tong, GD
Issue Date: 2018
Publisher: Public Library of Science
Source: PLoS one, 2018, v. 13, no. 9, e0203220, p. 1-16 How to cite?
Journal: PLoS one 
Abstract: Background The aim of this study is to reveal the clinical and histopathological features of HBsAg-positive and HBeAg-positive chronic hepatitis B infected patients with high level of HBV DNA, from 17 hospitals and medical centres in China, with alanine aminotransferase levels within the lower region of normal range versus those with levels within the upper region of normal range and to investigate the clinical risk factors for the requirement of treatment through the examination of liver biopsy.
Methods Liver biopsy was performed on high level of HBV DNA of 455 patients with HBsAg-positive and HBeAg-positive chronic hepatitis B infection and persistently normal alanine aminotransferase level. Liver necroinflammation and fibrosis were graded per the Knodell histological activity index and Ishak’s fibrosis score, respectively. Univariate analysis of the clinical parameters versus necroinflammation and fibrosis was carried out.
Results Results Of the Subjects in this multicentre-based study, 5.49% and 10.11% had significant necroinflammation with Knodell histological activity index 9 and hepatic fibrosis stages with Ishak scores 3, respectively. The subjects were stratified into three age groups (30–39, 40–49 and 50 years), and our data clearly suggested that age, particularly in the age group over 50, was an independent predictor of liver necroinflammation and fibrosis. Lower HBV-DNA viral levels were found in patients with Knodell histological activity index 9 or advanced fibrosis (Ishak scores 3).
Conclusion Our results showed that histological changes in liver tissues were observed in a significant proportion of patients with persistently normal alanine aminotransferase level. According to the data evaluation Results, liver biopsy is advisable for HBeAg-positive chronic hepatitis B infected patients aged older than 40 and high HBV-DNA viral load in China.
URI: http://hdl.handle.net/10397/80000
EISSN: 1932-6203
DOI: 10.1371/journal.pone.0203220
Rights: Copyright: © 2018 Xing et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The following publication Xing, Y. -., Zhou, D. -., He, J. -., Wei, C. -., Zhong, W. -., Han, Z. -., . . . Tong, G. -. (2018). Clinical and histopathological features of chronic hepatitis B virus infected patients with high HBV-DNA viral load and normal alanine aminotransferase level: A multicentre-based study in China. PLoS ONE, 13(9), e0203220, 1-16 is available at https://dx.doi.org/10.1371/journal.pone.0203220
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