Hepatic necroinflammation and severe liver fibrosis in patients with chronic hepatitis B with undetectable HBV DNA and persistently normal alanine aminotransferase

Authors

  • MM Alam Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka
  • MA Mahtab Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka
  • SMF Akbar Department of Medical Sciences, Toshiba General Hospital, Tokyo
  • M Kamal Department of Pathology, Bangabandhu Sheikh Mujib Medical University, Dhaka
  • S Rahman Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka

DOI:

https://doi.org/10.3329/bmrcb.v40i3.25229

Abstract

Both consensus and controversy remains regarding surrogacy of hepatitis B virus (HBV) deoxyribonucleic acid (DNA) and alanine aminotransferase (ALT), however, these markers are used to ascertain the extent of liver damages and to guide therapeutic options in patients with chronic hepatitis B. However, little is known about liver histology of patients with chronic hepatitis B with undetectable HBV DNA and persistently normal ALT. Thirty-five incidentally-detected patients with chronic HBV infection (assessed by expression of hepatitis B surface antigen for more than 6 months) with undetectable HBV DNA and normal serum ALT were enrolled in this study. Liver biopsy specimens were taken from all patients and the extent of hepatic necroinflammation and liver fibrosis were evaluated. Moderate degree of hepatic necroinflammation was detected in 2 of 35 patients and severe hepatic fibrosis was seen in 6 of 35 patients. Two patients with undetectable HBV DNA and sustained normal ALT had moderate hepatic necroinflammation and severe hepatic fibrosis. In spite of undetectable HBV DNA for prolonged period and persistently normal ALT, some patients with chronic hepatitis B express evidences of progressive liver diseases. Large scale studies in different races and geographical regions should be accomplished to develop insights about management of these patients. Studies about extent of liver diseases in these patients should be accomplished in Treatment recommendation and management strategies should be developed for these patients.

Bangladesh Med Res Counc Bull 2014; 40 (3): 92-96

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Author Biography

MM Alam, Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka



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Published

2015-10-05

How to Cite

Alam, M., Mahtab, M., Akbar, S., Kamal, M., & Rahman, S. (2015). Hepatic necroinflammation and severe liver fibrosis in patients with chronic hepatitis B with undetectable HBV DNA and persistently normal alanine aminotransferase. Bangladesh Medical Research Council Bulletin, 40(3), 92–96. https://doi.org/10.3329/bmrcb.v40i3.25229

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Section

Research Papers