Comparative study on guidelines in determining HBV phases in Iranian patients.
ALT level
CHB phases
Chronic hepatitis B
Iran
Journal
Gastroenterology and hepatology from bed to bench
ISSN: 2008-2258
Titre abrégé: Gastroenterol Hepatol Bed Bench
Pays: Iran
ID NLM: 101525875
Informations de publication
Date de publication:
2019
2019
Historique:
entrez:
27
2
2020
pubmed:
27
2
2020
medline:
27
2
2020
Statut:
ppublish
Résumé
The aim of this study was to compare the different phases of chronic Hepatitis B virus (HBV) infection with different values for normal ALT. For many years, the upper limit of 40 IU was considered normal for ALT for both sexes, but in recent years this value is challenged and some guidelines have lowered their limit. In this cross-sectional study, 2000 HBsAg positive patients who were referred to Taleghani Hospital, Tehran, Iran, from 2011 through 2018 were classified in four groups according to American Association of the study of the liver disease (AASLD), European Association of the study of the liver (EASL) /Asian-Pacific Association of the study of the liver (APASL) and American Collage of Gastroenterology (ACG) guidelines. The frequency of each group based on 3 different guidelines was compared. In HBeAg positive patients (n=100), the percentage of immune tolerance phase was 43% according to AASLD cutoff for normal ALT (35 IU for men, 25 IU for women), while it was 68% and 28% with regard to EASL/APASL and ACG (30 IU for men, 19 IU for women) cutoffs respectively. In HBeAg negative patients (n=1900), 66.68% were inactive carriers according to AASLD, but the percentage changed to 82.89% and 52.42% considering EASL/APASL and ACG values, respectively. Using ACG and to a lesser extent AASLD cutoff for ALT, many patients shift from immune tolerance and inactive carrier state into the immune active phase. Thus, more patients are candidates for treatment or intensive workup to determine the extent of liver damage.
Sections du résumé
AIM
OBJECTIVE
The aim of this study was to compare the different phases of chronic Hepatitis B virus (HBV) infection with different values for normal ALT.
BACKGROUND
BACKGROUND
For many years, the upper limit of 40 IU was considered normal for ALT for both sexes, but in recent years this value is challenged and some guidelines have lowered their limit.
METHODS
METHODS
In this cross-sectional study, 2000 HBsAg positive patients who were referred to Taleghani Hospital, Tehran, Iran, from 2011 through 2018 were classified in four groups according to American Association of the study of the liver disease (AASLD), European Association of the study of the liver (EASL) /Asian-Pacific Association of the study of the liver (APASL) and American Collage of Gastroenterology (ACG) guidelines. The frequency of each group based on 3 different guidelines was compared.
RESULTS
RESULTS
In HBeAg positive patients (n=100), the percentage of immune tolerance phase was 43% according to AASLD cutoff for normal ALT (35 IU for men, 25 IU for women), while it was 68% and 28% with regard to EASL/APASL and ACG (30 IU for men, 19 IU for women) cutoffs respectively. In HBeAg negative patients (n=1900), 66.68% were inactive carriers according to AASLD, but the percentage changed to 82.89% and 52.42% considering EASL/APASL and ACG values, respectively.
CONCLUSION
CONCLUSIONS
Using ACG and to a lesser extent AASLD cutoff for ALT, many patients shift from immune tolerance and inactive carrier state into the immune active phase. Thus, more patients are candidates for treatment or intensive workup to determine the extent of liver damage.
Types de publication
Journal Article
Langues
eng
Pagination
S145-S148Informations de copyright
©2019 RIGLD.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interest.
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