The effect of HBeAg positivity on susceptibility in noninvasive methods used to detect liver injury in chronic hepatitis B patients

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Habiloğlu A. D., Gürbüz Y., Ünver Ulusoy T., ŞAKAR C., Sencan İ.

Türk Hijyen ve Deneysel Biyoloji Dergisi, cilt.81, sa.1, ss.31-44, 2024 (Scopus, TRDizin)

Özet

Objective: Hepatitis B is a common health problem and deaths from acute or chronic hepatitis B are more than 600,000 per year. Liver damage that develops throughout the course of the disease forms the basis of mortality and morbidity. The most accurate and most difficult method to detect the extent of liver damage is liver biopsy. There are conflicting data in the literature regarding noninvasive methods.In HBeAg+ and HBeAg- patients, liver cell damage develops by different physiopathological mechanisms. We aimed to find more sensitive results by evaluating HBeAg + and HBeAg – patients in separate groups, which are biomarkers used as an alternative to liver biopsy. Methods: Patients over the age of 18, who were followed by the Infectious Diseases Clinics of Dışkapı Yıldırım Beyazıt Training and Research Hospital and Yıldırım Beyazıt University Yenimahalle Training and Research Hospital between 2010 and 2020, with HBs ag positivity for more than six months and with HBV DNA >2000 IU were evaluated. The patients were divided into two groups according to the presence of HBeAg. Afterwards, each group was divided into mild fibrosis or non-fibrosis group with a fibrosis score of less than 3, and patients with a score of 3 and above in the advanced fibrosis group, according to the histologically determined treatment indication. Indirect fibrosis indicators were evaluated separately in all patients and in all subgroups. Results: 191 CHB patients were included in the study. 89 male and 102 female patients comprised the entire cohort. Among the patients, there were 89 patients with fibrosis 3 or more, and 102 patients with fibrosis below 3. There were 48 HBeAg positive patients in the whole patient group and the patients were equally distributed regardless of fibrosis. No noninvasive marker was found to detect fibrosis in the entire cohort, only the histological activity index was associated with fibrosis. In the HBeAg-positive patient group, the API score, which increased with aging and low platelet counts, was associated with fibrosis, while in the HBeAg-negative patient group, total protein was associated with fibrosis. Conclusion: Determining fibrosis by non-invasive methods in chronic hepatitis B patients is important as it can be an alternative to biopsy for patient follow-up and treatment. When evaluating noninvasive methods that can detect liver damage, we emphasize the importance of evaluating patients by dividing them into appropriate subgroups. More studies are needed to determine the appropriate biomarkers to detect the severity of fibrosis in chronic hepatitis B patients.