Total serum bile acids predict therapy for HBeAg-negative chronic hepatitis B patients with borderline ALT and high HBV DNA

  • Ran Xie Department of Laboratory Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China https://orcid.org/0000-0002-1280-5004
  • Jiao Li Department of Laboratory Medicine, Changzheng Hospital, Naval Medical University, Shanghai, China https://orcid.org/0000-0002-5724-727X
  • Hao Zhang Department of Laboratory Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
  • Ling-mei Wang Department of Laboratory Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China https://orcid.org/0000-0001-6240-3938
  • Cheng-rong Huang Department of Laboratory Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
  • Li-wen Chen Department of Laboratory Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China https://orcid.org/0000-0001-8980-1557
Keywords: total serum bile acids, chronic hepatitis B, antiviral therapy, hepatic lesions, noninvasive model

Abstract

Introduction: The introduction of antiviral therapy in chronic hepatitis B (CHB) infection depends on precise evaluation of hepatic lesions. Total serum bile acids (TSBAs) are highly sensitive in monitoring liver dysfunction. We evaluated the predictive role of TSBAs for hepatic lesions in CHB patients with borderline alanine aminotransferase (ALT) and high level of hepatitis B virus (HBV) DNA copies.

Methodology: 328 CHB patients were enrolled, 241 were hepatitis B e antigen (HBeAg)-positive and 87 were HBeAg-negative. Patients were further divided into two entities according to inflammation/fibrosis evaluated by liver biopsy, low-grade (inflammation grade < 2 and fibrosis stage < 2) and high-grade (inflammation grade ≥ 2 or/and fibrosis stage ≥ 2) cohorts. TSBAs were compared with noninvasive tools including aspartate aminnotransferase (AST)-to-platelet ratio index (APRI), fibrosis-4 (FIB-4) and red cell distribution width (RDW)-to-platelet ratio (RPR) to predict high-grade hepatic lesions in CHB subgroups.

Results: TSBAs, APRI, FIB-4 and RPR were statistically different between low- and high-grade patients in HBeAg-positive cohort. Only TSBAs showed significant difference between low and high grade in HBeAg-negative patients. Similarly, APRI, FIB-4 and RPR were correlated with different division of inflammation/fibrosis only in HBeAg-positive while TSBAs were correlated with inflammation/fibrosis levels in both HBeAg-positive and HBeAg-negative groups. Of the four indicators, the receiver operating characteristic (ROC) curve analysis showed that TSBAs have the maximum AUC (area under the curve) in HBeAg-negative group but the minimum in HBeAg-positive cohort.

Conclusions: TSBAs can be used for predicting antiviral therapy in CHB patients with HBeAg-negative, borderline ALT and high HBV DNA.

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Published
2022-08-30
How to Cite
1.
Xie R, Li J, Zhang H, WangL- mei, HuangC- rong, ChenL- wen (2022) Total serum bile acids predict therapy for HBeAg-negative chronic hepatitis B patients with borderline ALT and high HBV DNA. J Infect Dev Ctries 16:1336-1342. doi: 10.3855/jidc.15915
Section
Original Articles