Relationship between biochemical and viral parameters and histopathological findings in patients with chronic hepatitis B

Objective: Chronic hepatitis B (CHB) infection can be seen in as wide spectrum of disease as asymptomatic carrier to cirrhosis and can lead to important complications such as hepatic failure and hepatocellular carcinoma (HCC). In chronic viral hepatitis, liver biopsy is currently used as a standard for determining histological activity and fibrosis level. This study examined the relationship between viral markers and liver function tests and liver biopsy results. Methods: The study included patients with CHB who were followed at the Gastroenterology unit at the Dicle University Medical Faculty. Patients' demographic characteristics, HBsAg, HBeAg, anti-HBe, HBV DNA, ALT, AST, ALP, GGT, total bilirubin levels and histological activity index (HAI) and fibrosis stage data were retrospectively recorded. Results: 252 patients with CHB (77 females, 175 males) were included in the study. The mean age of all patients was calculated as 37±12 years. It was found that there was a statistically significant correlation between fibrosis and ALT (p<0.0001, r=0.319), AST (p<0.0001, r=0.344) and GGT (p=0.001, r=0.258). It was found that there was no statistically significant relationship between HBsAg (p=0.111) and HBV DNA (p=0.081) with fibrosis. When the patients were divided into 3 groups as HAI minimal (1-3), mild (4-8), and middle (9-12) and the relationship with laboratory parameters was evaluated; a statistically significant positive correlation was found between the ALT (p<0.0001, r=0.367), AST (p<0.0001, r=0.384), ALP (p=0.038, r=0.139), GGT (p<0.0001, r=0.242) and HBV DNA (p=0.002, r=0.231) levels and the severity of HAI. However, no correlation was found between HBsAg (p=0.817) and HAI. In conclusion, there is a growing need for readily reproducible biochemical tests that are now thought to demonstrate advanced stage liver fibrosis. According to my work; ALT, AST, GGT levels are important parameters in predicting HAI and fibrosis stage in liver biopsy. In addition, HBV DNA level is an important parameter in predicting HAI. The results of HBsAg and HBeAg liver biopsy appear to be insignificant. Keywords: Chronic Hepatitis B, Histology, Biochemistry