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Characteristics of chronic hepatitis B: Lower alanine transaminase level to start treatment in HBEAG Negatives
  1. M S Alam *1,
  2. G Azam2,
  3. G Mustafa1,
  4. N Ahmad1,
  5. M Khan1
  1. 1Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  2. 2GHPD, Birrdem, Dhaka, Bangladesh


Introduction Chronic hepatitis B (CHB) is being divided into two groups scientifically with respect to HBeAg status. Different DNA levels are considered for starting treatment in two groups. We have designed this study to explore different characteristics of CHB.

Methods We have included 2453 CHB patients of male predominating 2193 (89.4%) during the period of March 2007–October 2009. Other causes of hepatitis were excluded. Histological activity index (HAI) and fibrosis were studied in 463 cases and multivariate logistic regression analysis were done with different factors. Sensitivity and specificity were determined from receiver operating characteristic curve.

Results Of the total, 1288 (52.5%) were HBeAg negative who were significantly older, containing less DNA and alanine transaminase (ALT) and more fibrotic than HBeAg positives with insignificant differences in histological activity. Log DNA (p= 0.002; 0.006) and ALT (p= 0.001; 0.04) had strong positive correlation with HAI and fibrosis in HBeAg negatives. ALT level of 60 had better prediction of HAI 9 than that of 80 U/l. Only ALT had positive correlation with HAI and fibrosis (p= 0.01) in HBeAg positives. Age, sex and AST/ALT didn't influence histological changes in both groups.

Conclusion ALT and DNA level have strong positive correlation with histological changes in HBeAg negatives but DNA doesn't have with HBeAg positives. ALT level of 60 U/L is recommended to start treatment in HBeAg negative CHB.

  • alanine transaminase
  • CHB
  • fibrosis
  • histological activity

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  • Competing interests None.

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