Observation of inflammation grade and fibrosis stage in chronic hepatitis B patients with low level of HBsAg

Abstract

Abstract: Objective To observe the characteristics of inflammation grade and fibrosis stage in patients with chronic hepatitis B (CHB) with low level of hepatitis B surface antigen (HBsAg). Methods We selected 157 cases of low level of HBsAg in CHB patients from May 2018 to May 2020, all patients admitted to hospital after receiving liver biopsy before treatment, serum HBsAg and HBV DNA, platelet (PLT), total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST) examination. According to the liver puncture results, the differences of the above serum indexes among patients with different grades of inflammatory activity and fibrosis stages were analyzed. Finally, Spearman rank correlation analysis was used to test the correlation between serum PLT and the fibrotic grading period of CHB patients with low HBsAg levels. Results Among 157 CHB patients, the inflammatory activity grades of 43 cases were G1 grade, 56 cases were G2 grade, 40 cases were G3 grade, and 18 cases were G4 grade. Fibrosis stages of 44 cases were S1 stage, 53 cases with S2 stage, 42 cases with S3 stage, and 18 cases with S4 stage. Comparison of levels of HBsAg, HBV DNA, PLT, TBIL, ALT and AST in patients with different grades of inflammatory activity (P>0.05). The levels of HBsAg, HBV DNA, TBIL, ALT and AST in patients with different fibrosis stages were compared (P>0.05). PLT levels in patients with fibrosis stage S1, 2, 3 and 4 were (214.15 ± 24.16) × 10⁹/L, (174.26 ± 15.06) × 10⁹/L, (144.75 ± 10.46) × 10⁹/L, (130.76 ± 5.56) × 10⁹/L, respectively. PLT levels in patients with different fibrosis stages were S1 > S2 > S3 > S4 (P<0.05). The correlation analysis confirmed that PLT was negatively correlated with fibrosis stage in CHB patients with low level of HBsAg (P<0.05). Correlation analysis confirmed that PLT was negatively correlated with fibrosis stage in CHB patients with low HBsAg level (r=-0.516, P<0.05). Conclusion CHB patients with low HBsAg level still had liver tissue inflammation and fibrosis, and the correlation analysis confirmed that PLT level was closely related to fibrosis stage, clinicians should pay attention to it.

Key words: Chronic hepatitis B, Hepatitis B surface antigen, Inflammation, Fibrosis, Liver biopsy

XIAO Shan-shan, YANG Qiao-hong, LI Jian-ting. Observation of inflammation grade and fibrosis stage in chronic hepatitis B patients with low level of HBsAg[J]. Chinese Hepatolgy, 2022, 27(2): 225-227.

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