Role of Liver Biopsy in HBV Infected Egyptian Patients: A New Insight
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2017, Vol 19, Issue 2
Abstract
Background: In chronic hepatitis B (HBV) Egyptian patients; international guidelines showed a wide discrepancy in validity of liver biopsy as a prerequisite to solve the dilemma of whether to start treatment or not. Aim: Evaluating role of liver biopsy in deciding to treat or not Egyptian patients with chronic HBV irrespective of HBV-DNA and/or ALT levels. Methods: This prospective study was carried out on four equal groups of chronic HBV Egyptian patients, selected from viral hepatitis clinic, National Liver Institute, Menofia University. They were classified according to their HBV DNA and ALT levels. All patients were HBsAg positive for at least 6 months, detectable HBV-DNA by PCR, with no prior submission for antiviral regimens. Liver biopsy was performed and analyzed according to Metavir scoring systems. Results: Patients were 32.2 years old with 87.3% male prevalence. 88% of patients were HBeAg negative with 22% showing significant pathology {fibrosis (F) ≥2 and/or necroinflamatory activity (A) ≥2}. Patients eligible for treatment according to EASL 2009 guidelines were 39%, decreased to 29% with implementation of high ALT versus 22% when treatment decision was based on liver biopsy. While only 10.7% were eligible for treatment according to ASSLD 2009 guidelines, decreased to 4.3% with implementation of high ALT levels versus 22.3% when treatment decision was based on liver biopsy findings. Conclusion: In spite of the discrepancy between treatment indications using either EASL 2009 or ASSLD 2009 guidelines, liver biopsy was more reliable in deciding which chronic HBV Egyptian patients to be treated, irrespective of HBV-DNA and/ or ALT level.
Authors and Affiliations
Khaled Gameel, Maha M. Elsabaawy, Madiha Naguib, Nermine Ehsan, Dina Alazab, Mohsen Salama, Eman A. Rewisha
Keywords
Related Articles
- EP ID EP311221
- DOI 10.9734/BJMMR/2017/29830
- Views 60
- Downloads 0
Myotonic Dystrophy: Accurately Scoring the Boundaries that Define Regions of Triplet Repeat Expansion Mutations
Aims: Myotonic Dystrophy type 1 (DM1) is an autosomal dominant neuromuscular multi-systemic disorder caused by a CTG triplet repeat expansion mutation in the DMPK gene. The clinical decision points defining the CTG repea...
It is Time That Health Authorities Promote the Use of Oxygen-ozone Therapy as an Integrative Therapy of Orthodox Drugs
Ozone is a very reactive gas and is toxic for the respiratory system but, under precise rules, it can be therapeutically useful for human disease with a chronic oxidative stress. An unfavorable combination of factors suc...
Physical Fitness and Prevalence of Musculoskeletal Pain amongst Dentists and Dental Students in Mumbai City: A Questionnaire-based, Cross-sectional Study
Introduction: Musculoskeletal pain is one of the most common complaints amongst dental healthcare professionals by virtue of the precision of work demanded from them, which leads to unnatural, static postures and repetit...
Prevalence and Severity of ECG Anomalies in a Rural Australian Population
Aims: To determine the prevalence and severity of cardiac arrhythmias in a rural Australian population using ECG assessment. Study Design: This is a University-based research project. Comparative design with random samp...
Prevalence of Dysmenorrhea and Its Sequel among Medical Students in a Malaysian University
Introduction: Dysmenorrhea is a common gynecological problem among women of reproductive age group which can have an impact on professional and psycho-social life. Objectives: To estimate the prevalence of dysmenorrhea,...