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dc.contributor.authorÖrmeci, Aslı
dc.contributor.authorAydın, Yücel
dc.contributor.authorŞumnu, Abdullah
dc.contributor.authorBaran, Bülent
dc.contributor.authorMutluay Soyer, Özlem
dc.contributor.authorPınarbaşı, Binnur
dc.contributor.authorGöktürk, Suut
dc.contributor.authorGüllüoǧlu, Mine
dc.contributor.authorÖnel, Derya
dc.contributor.authorBadur, Selim
dc.contributor.authorAkyüz, Filiz
dc.contributor.authorKaraca, Çetin
dc.contributor.authorDemir, Kadir
dc.contributor.authorBeşışık, Fatih
dc.contributor.authorKaymakoğlu, Sabahattin
dc.identifier.citationÖrmeci, A., Aydın, Y., Şumnu, A., Baran, B., Mutluay Soyer, Ö., Pınarbaşı, B. ... Kaymakoğlu, S. (2016). Predictors of treatment requirement in HBeAg-negative chronic hepatitis B patients with persistently normal alanine aminotransferase and high serum HBV DNA levels. 52, 68-73.
dc.descriptionWOS: 000389516600014en_US
dc.descriptionPubMed ID: 27619844en_US
dc.description.abstractObjectives: Serum alanine aminotransferase (ALT) is a controversial marker for disease monitoring in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients. The aim of this study was to determine the fibrosis stage and histological activity index (HAI) in HBeAg-negative CHB patients with persistently normal ALT (PNALT) and high serum HBV DNA (>= 2000 IU/ml) and to investigate clinical risk factors for the requirement of treatment through the examination of liver biopsy specimens. Methods: HBeAg-negative CHB patients with PNALT (<= 40 IU/l) and high serum HBV DNA (>= 2000 IU/ml) were included. HBV fibrosis stage and HAI were scored according to the Ishak system. Multivariate logistic regression analysis was used to estimate the independent risk factors for fibrosis stage >= 2 and/or HAI >= 6. Receiver operating characteristic curve analysis was used to determine an optimal age cut-off for liver biopsy. Results: A total 120 patients were enrolled. These patients had a mean HBV DNA level of 123 680 +/- 494 500 IU/ml; the HBV DNA load was 2000-20 000 IU/ml in 68 patients (56.6%) and >= 20 000 IU/ml in 52 (43.4%). Eighteen patients (15%) had moderate-to-severe histological activity (HAI >= 6). Forty-three patients (35.9%) had a fibrosis stage >= 2. Forty-eight patients (40%) had a fibrosis stage >= 2 and/or HAI >= 6. On multivariate logistic regression analysis, independent variables associated with fibrosis stage >= 2 and/or HAI >= 6 included age and HBV DNA viral load. Patients with HBV DNA 2000-20 000 IU/ml were more likely to require treatment compared to those with a viral load >= 20 000 IU/ml. The optimal age cut-off to predict fibrosis stage >= 2 and/or HAI >= 6 was 46 years. Conclusions: Significant liver damage was detected in 40% of CHB patients with PNALT and high HBV DNA upon biopsy. Age and HBV DNA viral load were independent predictors of significant liver damage. A biopsy to determine the degree of liver damage is advisable for CHB patients older than 46 years.en_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.subjectChronic Hepatitis Ben_US
dc.subjectPersistently Normal ALTen_US
dc.titlePredictors of treatment requirement in HBeAg-negative chronic hepatitis B patients with persistently normal alanine aminotransferase and high serum HBV DNA levelsen_US
dc.relation.ispartofInternational Journal of Infectious Diseasesen_US
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalıen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US

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