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- Title
Evaluation of Alanine Transaminase and Hepatitis B Virus DNA to Predict Liver Cirrhosis in Hepatitis B e Antigen-Negative Chronic Hepatitis B Using Transient Elastography.
- Authors
Wong, Grace Lai-Hung; Wong, Vincent Wai-Sun; Choi, Paul Cheung-Lung; Chan, Anthony Wing-Hung; Chim, Angel Mei-Ling; Yiu, Karen Ka-Lam; Chan, Hoi-Yun; Chan, Francis Ka-Leung; Sung, Joseph Jao-Yao; Chan, Henry Lik-Yuen
- Abstract
BACKGROUND AND AIMS: We aimed to investigate the relationship between serum hepatitis B virus (HBV) DNA and alanine transaminase (ALT) levels and the risk of cirrhosis in a large cohort of hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients based on transient elastography. METHODS: We prospectively studied treatment-naive HBeAg-negative patients recruited based on territory-wide referrals. We defined possible cirrhosis and probable cirrhosis with two different cutoffs according to the results from a subgroup of patients with histologic proof. RESULTS: One thousand one hundred ninety-seven patients with successful liver stiffness measurement (LSM) were studied. In the subgroup of 100 patients with liver biopsy, LSM of ≥8.4 kiloPascal (kPa) had a sensitivity of 90% and LSM of ≥13.4 kPa had a specificity of 94% for liver cirrhosis. Possible and probable cirrhosis were defined as a LSM value ≥8.4 kPa and ≥13.4 kPa, and were present in 31% and 11% of the patients, respectively. The risk of cirrhosis was significantly increased when ALT level was >0.5× upper limit of normal (ULN) or serum HBV DNA >4 log10 copies/mL. Among patients who have ALT ≤0.5 × ULN and HBV DNA ≤4 log10 copies/mL, 10% (26/264) and 3% (7/264) had possible and probable cirrhosis respectively, which were significantly lower when compared with 34% (329/887, P < 0.001) and 14% (125/887, P < 0.001) of those who had higher ALT and HBV DNA levels. CONCLUSIONS: Liver cirrhosis was common among HBeAg-negative CHB patients. Patients with ALT levels >0.5 × ULN and/or serum HBV DNA >4 log10 copies/mL have higher risk of cirrhosis and need further assessment for antiviral therapy.
- Subjects
CIRRHOSIS of the liver; ALANINE aminotransferase; HEPATITIS B; ANTIVIRAL agents; TUMOR growth; DIAGNOSIS; GENETICS
- Publication
American Journal of Gastroenterology (Springer Nature), 2008, Vol 103, Issue 12, p3071
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.2008.02157.x