OZLEM KIRISCI*, TUGBA PAKSOY**, AHMET CALISKAN*, ASIYE ANALAN**, ESRA OZKAYA***, BEYHAN KIRMACI**, SERAY TUMER*, RANA CITIL**, GURKAN CIKIM****, SULE AGIRBAS**, ZEKI GUZEL**, HANDE SENOL*****
*Necip Fazil City Hospital, Department of Medical Microbiology, Kahramanmaras, Turkey -
**Necip Fazıl City Hospital, Department of Medical Pathology, Kahramanmaras, Turkey -
***Karadeniz Technical University Faculty of Medicine, Department of Medical Microbiology, Trabzon, Turkey -
****Necip Fazıl City Hospital, Department of Medical Biochemistry, Kahramanmaras, Turkey -
*****Pamukkale University Faculty of Medicine, Department of Biostatistics, Denizli, Turkey
Introduction: Determination of Hepatitis B virus (HBV) by molecular methods is increasingly common. Together with biochemical and serological diagnostic methods and a histopathological assessment is important to detect necrosis, inflammation, and fibrosis in the liver. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values are tests often used to predict the histological stages of chronic hepatitis.
Materials and methods: One hundred seventy-three patients who were referred to the Kahramanmaras Necip Fazıl City Hospital Microbiology Laboratory with prediagnosis of HBV infection between September 2012-January 2016, were evaluated with necroinflammatory activity levels/ histological activity index (HAI) and fibrosis scores according to the ISHAK classification criteria, and the results were compared with alanine aminotransferase (ALT), aspartate aminotransferase (AST), and HBV-DNA serum levels of the time of biopsy.
Results: The study included 63 female and 109 male patients. The mean age was 39.39±13.4 years. There was statistically significant difference in age, ALT, AST, and HBV DNA levels between patients in the high fibrosis group and the low fibrosis group (p: 0.034, 0.002, 0.0001, and 0.007, respectively). There was significant difference between patients from severe HAI and mild to moderate HAI groups in terms of AST values (p: 0.045). AST was found to be a risk factor for fibrosis, and ALT and AST were found to be risk factors for HAI. HBV DNA, ALT, and AST levels of HBe-Ag positive patients were significantly higher compared to HBe-Ag negative patients (p:0,0001, 0,027, 0,008).
Conclusions: In our study, advanced age, high HBV DNA, ALT and AST levels were found to be associated with fibrosis, and high AST levels were found to be associated with liver necroinflammation. It is thought that serum ALT and AST levels could be useful parameters for liver necroinflammation and fibrosis. Evaluation of these parameters in chronic hepatitis B patients as indicator parameters for advanced stages of fibrosis and necroinflammation would be a right approach.
Hepatitis B virus, fibrosis, histological activity index, alanine aminotransferase.