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Characteristics of an outpatient chronic hepatitis B virus infection cohort
OBJECTIVE: To characterize a chronic hepatitis B cohort based on initial and follow-up clinical evaluations. METHODS: A retrospective and descriptive analysis of clinical and laboratory data from chronic HBsAg adult carriers, without HIV, unexposed to treatment, with at least two outpatient visits,...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Instituto de Ensino e Pesquisa Albert Einstein
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943808/ https://www.ncbi.nlm.nih.gov/pubmed/26154539 http://dx.doi.org/10.1590/S1679-45082015AO3269 |
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author | de Assis, Danyenne Rejane Tenore, Simone de Barros Pinho, João Renato Rebello Lewi, David Salomão Ferreira, Paulo Roberto Abrão |
author_facet | de Assis, Danyenne Rejane Tenore, Simone de Barros Pinho, João Renato Rebello Lewi, David Salomão Ferreira, Paulo Roberto Abrão |
author_sort | de Assis, Danyenne Rejane |
collection | PubMed |
description | OBJECTIVE: To characterize a chronic hepatitis B cohort based on initial and follow-up clinical evaluations. METHODS: A retrospective and descriptive analysis of clinical and laboratory data from chronic HBsAg adult carriers, without HIV, unexposed to treatment, with at least two outpatient visits, between February 2006 and November 2012. Fisher´s exact test, χ², Wilcoxon, Spearman, multiple comparisons and Kappa tests were applied, the level of significance adopted was 5%, with a 95% confidence interval. RESULTS: 175 patients with mean age of 42.95±12.53 years were included: 93 (53.1%) were men, 152 (86.9%) were negative for hepatitis B e-antigen (HBeAg), 3 (1.7%) had hepatitis C coinfection, 15 (8.6%) had cirrhosis, and 2 (1.1%) had hepatocellular carcinoma. Genotype A predominated. Sixty-six patients (37.7%) had active hepatitis, 6 (3.4%) presented immune tolerance, and 38 (21.7%) were inactive carriers. Exacerbations and/or viral breakthrough were detected in 16 patients (9.1%). In 32 patients (18.3%), hepatitis B virus DNA remained persistently elevated and alanine aminotransferase levels were normal, whereas in 17 (9.7%), there was low hepatitis B virus DNA and alterated alanine aminotransferase. If only initial alanine aminotransferase and hepatitis B virus DNA values were considered, 15 cases of active hepatitis would not have been detected. Advanced fibrosis was more common in HBeAg-positive patients, and it was significantly associated with transaminases, hepatitis B virus DNA, and age. CONCLUSION: Many patients had active hepatitis, but almost 25%, who were HBeAg non-reactive, were only identified because of combined analyses of the hepatitis B virus DNA and transaminases levels, sometimes associated with histological data, after clinical follow-up. |
format | Online Article Text |
id | pubmed-4943808 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Instituto de Ensino e Pesquisa Albert Einstein |
record_format | MEDLINE/PubMed |
spelling | pubmed-49438082016-08-10 Characteristics of an outpatient chronic hepatitis B virus infection cohort de Assis, Danyenne Rejane Tenore, Simone de Barros Pinho, João Renato Rebello Lewi, David Salomão Ferreira, Paulo Roberto Abrão Einstein (Sao Paulo) Original Article OBJECTIVE: To characterize a chronic hepatitis B cohort based on initial and follow-up clinical evaluations. METHODS: A retrospective and descriptive analysis of clinical and laboratory data from chronic HBsAg adult carriers, without HIV, unexposed to treatment, with at least two outpatient visits, between February 2006 and November 2012. Fisher´s exact test, χ², Wilcoxon, Spearman, multiple comparisons and Kappa tests were applied, the level of significance adopted was 5%, with a 95% confidence interval. RESULTS: 175 patients with mean age of 42.95±12.53 years were included: 93 (53.1%) were men, 152 (86.9%) were negative for hepatitis B e-antigen (HBeAg), 3 (1.7%) had hepatitis C coinfection, 15 (8.6%) had cirrhosis, and 2 (1.1%) had hepatocellular carcinoma. Genotype A predominated. Sixty-six patients (37.7%) had active hepatitis, 6 (3.4%) presented immune tolerance, and 38 (21.7%) were inactive carriers. Exacerbations and/or viral breakthrough were detected in 16 patients (9.1%). In 32 patients (18.3%), hepatitis B virus DNA remained persistently elevated and alanine aminotransferase levels were normal, whereas in 17 (9.7%), there was low hepatitis B virus DNA and alterated alanine aminotransferase. If only initial alanine aminotransferase and hepatitis B virus DNA values were considered, 15 cases of active hepatitis would not have been detected. Advanced fibrosis was more common in HBeAg-positive patients, and it was significantly associated with transaminases, hepatitis B virus DNA, and age. CONCLUSION: Many patients had active hepatitis, but almost 25%, who were HBeAg non-reactive, were only identified because of combined analyses of the hepatitis B virus DNA and transaminases levels, sometimes associated with histological data, after clinical follow-up. Instituto de Ensino e Pesquisa Albert Einstein 2015 /pmc/articles/PMC4943808/ /pubmed/26154539 http://dx.doi.org/10.1590/S1679-45082015AO3269 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article de Assis, Danyenne Rejane Tenore, Simone de Barros Pinho, João Renato Rebello Lewi, David Salomão Ferreira, Paulo Roberto Abrão Characteristics of an outpatient chronic hepatitis B virus infection cohort |
title | Characteristics of an outpatient chronic hepatitis B virus infection cohort |
title_full | Characteristics of an outpatient chronic hepatitis B virus infection cohort |
title_fullStr | Characteristics of an outpatient chronic hepatitis B virus infection cohort |
title_full_unstemmed | Characteristics of an outpatient chronic hepatitis B virus infection cohort |
title_short | Characteristics of an outpatient chronic hepatitis B virus infection cohort |
title_sort | characteristics of an outpatient chronic hepatitis b virus infection cohort |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943808/ https://www.ncbi.nlm.nih.gov/pubmed/26154539 http://dx.doi.org/10.1590/S1679-45082015AO3269 |
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