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Category: Volume 07 Issue 01 January 2019
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Title: Epidemiological and Histological Features of Chronic Hepatitis B with low Level DNA with or without Transaminitis

Authors: Dr Shabir Ahmad Shiekh, Dr Ghulam Nabi Yattoo, Dr Majid Khalil

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.151

Abstract

Aims: Management of Chronic Hepatitis B patients with HBV DNA below 2000 iu/ml continues to be gray zone area. We evaluated the clinical, epidemiological and histological characteristics of with low level DNA with or without transaminitis.

Materials and Methods: 90 adult patients of chronic hepatitis B with serum DNA<2000 iu/ml with normal or raised serum ALT levels were included in the study after predetermined inclusion and exclusion criteria. Liver biopsy was performed in all of them for fibrosis assessment on Metavir system.

Results: Out of 90 patients, 70 (77.8%) were males and 20 (22.2%) were females. Liver biopsy as staged on Metavir scoring system revealed 60/90 (i.e. 66.7%) patients had F0 i.e. no fibrosis. 30/90 (33%) patients had some fibrosis (≥F1) though significant fibrosis i.e. F2 and F3 was seen in 8/90 (9%) patients. 

Conclusion: Chronic hepatitis B patients with serum DNA <2000 IU/ml were found to have some fibrosis i.e. Metavir F1, F2, F3 fibrosis in 30 patients (33%), 8 patients i.e. 9% had significant fibrosis (≥F2). All the Chronic hepatitis B patients irrespective of the HBV DNA or ALT levels must have fibrosis assessment. If there is significant fibrosis, on liver biopsy, they should be treated irrespective of DNA levels.

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Corresponding Author

Dr Shabir Ahmad Shiekh

Department of Gastroenterology, Superspeciality Hospital, Govt Medical College, Srinagar, Jammu and Kashmir, India

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