The relationship between clinical features and pathological diagnosis by liver biopsy in 431 carriers with chronic hepatitis B virus

Objective To evaluate the relationship between the liver inflammation and fibrosis( GS) stage and clinical features in 431 chronic hepatitis B carriers with positive HBV DNA. Methods 431 patients were divided into 4groups according to the ALT level: group A: ALT≤0. 5 × ULN,group B: 0. 5 × ULN ALT≤1 × ULN,group C: 1 ×ULN ALT≤2 × ULN,group D: 2 × ULN ALT≤5 × ULN,the GS stages were compared in the four groups. The differences between liver GS stages and clinical data were analysed in different ALT groups. Results There were significant difference between different ALT levels and GS stage,P 0. 05. 30. 62% in group B and 35. 47% in group C patients had G2-4 inflammation,49. 24% in group B and 49. 42% in group C patients had S2-4 fibrosis. The differences were statistically significant between the GS stage and clinical data in the four groups of patients( P 0. 05). The difference in levels of GLB,AST,GGT,PLT and APRI index in different liver inflammation groups were statistically significant,likewise,the different ages,ALB,AST,PLT,HBV DNA in different liver fibrosis groups were statistically significant( P 0. 05). The HBV DNA levels and APRI index were independent predictors of the degree of liver fibrosis. Conclusions Chronic HBV patients,even if the ALT level was less than 2 times of the ULN,a part of patients still have the significant progression of liver inflammation and fibrosis. Hence,these patients must be evaluated for antiviral treatments according to AST,GGT,APRI,HBeAg status and HBV DNA levels. Liver biopsy is recornmeded if necessary.