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Lesmana C.R.A., Gani R.A., Hasan I., Simadibrata M., Sulaiman A.S., Pakasi L.S., Budihusodo U., Krisnuhoni E., Lesmana L.A.
8977683000;23495930300;12776850800;23499598400;56926804000;6505566308;24785711400;35310982200;55920139300;
Significant hepatic histopathology in chronic hepatitis B patients with serum ALT less than twice ULN and high HBV-DNA levels in Indonesia
2011
Journal of Digestive Diseases
12
6
476
480
11
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia; Digestive Disease Center, Medistra Hospital, Jakarta, Indonesia; Department of Anatomical Pathology, University of Indonesia, Jakarta, Indonesia
Lesmana, C.R.A., Division of Gastroenterology and Hepatology, Department of Internal Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia, Digestive Disease Center, Medistra Hospital, Jakarta, Indonesia; Gani, R.A., Division of Gastroenterology and Hepatology, Department of Internal Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia; Hasan, I., Division of Gastroenterology and Hepatology, Department of Internal Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia; Simadibrata, M., Division of Gastroenterology and Hepatology, Department of Internal Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia; Sulaiman, A.S., Division of Gastroenterology and Hepatology, Department of Internal Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia; Pakasi, L.S., Digestive Disease Center, Medistra Hospital, Jakarta, Indonesia; Budihusodo, U., Division of Gastroenterology and Hepatology, Department of Internal Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia; Krisnuhoni, E., Department of Anatomical Pathology, University of Indonesia, Jakarta, Indonesia; Lesmana, L.A., Division of Gastroenterology and Hepatology, Department of Internal Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia, Digestive Disease Center, Medistra Hospital, Jakarta, 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 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. © 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.
Chronic hepatitis B; Normal alanine aminotransferase; Significant liver histopathology
alanine aminotransferase; hepatitis B(e) antigen; adolescent; adult; aged; article; female; genotype; hepatitis B; Hepatitis B virus; histopathology; human; Indonesia; major clinical study; male; prevalence; priority journal; prospective study; Adolescent; Adult; Aged; Alanine Transaminase; Biopsy; DNA, Viral; Female; Genotype; Hepatitis B e Antigens; Hepatitis B virus; Hepatitis B, Chronic; Humans; Incidence; Indonesia; Liver; Liver Cirrhosis; Male; Middle Aged; Prospective Studies; Retrospective Studies; Severity of Illness Index; Young Adult
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