Characteristics of treatment naïve chronic hepatitis B in Bangladesh: younger populations are more affected; HBeAg-negatives are more advanced.
Characteristics of treatment naïve chronic hepatitis B in Bangladesh: younger populations are more affected; HBeAg-negatives are more advanced.
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DOI：
10.4103/1319-3767.37796
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发表时间：
2008-01
期刊：
影响因子：
--
通讯作者：
Khan M
中科院分区：
文献类型：
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作者：
Alam S;Ahmad N;Mustafa G;Alam K;Khan M
孟加拉国是一个人口稠密的国家，慢性乙型肝炎 (CHB) 处于中等流行状态。本研究的目的是评估慢性乙型肝炎患者的生化、病毒学和组织学特征，并检查这些指标之间的关系。 122 名慢性乙型肝炎患者符合我们的纳入标准。纳入标准为 (1) HBsAg 阳性至少 6 个月，(2) HBeAg 阳性或阴性，以及 (3) 乙型肝炎病毒 (HBV) DNA 阳性。具有可检测到的人类免疫缺陷病毒（HIV）、丁型肝炎病毒（HDV）或丙型肝炎病毒（HCV）抗体、既往接受过抗病毒治疗、明显肝硬化和肝细胞癌的患者被排除在外。其中，随机选择 191 名患者进行肝活检并进行评估分析。 191例患者中，男女比例为4.6：1；年龄分布为 26.5 ± 8.5（平均值 ± 标准差）岁。 178 名 (93.2%) 患者年龄在 40 岁以下。 68 名 (35.6%) 患者 HBeAg 阴性，DNA 载量较少，且年龄明显较大，纤维化和肝硬化程度更高 (P < 0.001)。 DNA 水平和组织学活性之间未发现相关性。 HBeAg 阳性患者的组织学活动与 ALT 水平不相关 (P < 0.001)。慢性乙型肝炎影响孟加拉国的年轻人口。 HBeAg 阳性慢性乙型肝炎与更多的纤维化和肝硬化有关。所有患者的血清 HBV DNA 水平与组织学病变的严重程度并不相关。肝活检评估仍然是做出治疗决定的金标准。
Bangladesh is a densely populated country with intermediate endemicity for chronic hepatitis B (CHB). The aim of the present study was to evaluate the biochemical, virological and histological character of CHB patients and to examine the relationship between these indices. One thousand and twenty-two patients of CHB fulfilled our inclusion criteria. Inclusion criteria were (1) HBsAg positive for at least 6 months, (2) HBeAg-positive or negative and (3) hepatitis B virus (HBV) DNA positive. Patients with detectable antibodies to human immunodeficiency virus (HIV), hepatitis Delta virus (HDV) or hepatitis C virus (HCV), with previous antiviral treatment, overt cirrhosis and hepatocellular carcinoma, were excluded. Of these, 191 patients were randomly selected for liver biopsy and were evaluated for analysis. In the 191 patients, male to female ratio was 4.6:1; age distribution was 26.5 ± 8.5 (mean ± standard deviation) years. One hundred and seventy-eight (93.2%) patients were under 40 years. Sixty-eight (35.6%) patients were HBeAg-negative, had less DNA load, and were significantly older, more fibrotic and cirrhotic (P < 0.001). Correlation was not found between DNA level and histological activity. Histological activity was not correlated with ALT level in HBeAg-positive patients (P < 0.001). CHB affects the younger population in Bangladesh. HBeAg-positive CHB was associated with more fibrosis and cirrhosis. Serum HBV DNA levels do not correlate with the severity of histological lesions in all patients. Evaluation by liver biopsy remains gold standard for taking decision of treatment.