Characteristics of an outpatient chronic hepatitis B virus infection cohort
ABSTRACT Objective: To characterize a chronic hepatitis B cohort based on initial and follow-up clinical evaluations. Methods: A retrospective and descriptive analysis of clinical and laboratory data from chronic HBsAg adult carriers, without HIV, unexposed to treatment, with at least two outpatie...
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Instituto Israelita de Ensino e Pesquisa Albert Einstein
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015000200004&lng=en&tlng=en |
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| author | Danyenne Rejane de Assis Simone de Barros Tenore João Renato Rebello Pinho David Salomão Lewi Paulo Roberto Abrão Ferreira |
| author_facet | Danyenne Rejane de Assis Simone de Barros Tenore João Renato Rebello Pinho David Salomão Lewi Paulo Roberto Abrão Ferreira |
| author_sort | Danyenne Rejane de Assis |
| collection | DOAJ |
| description | ABSTRACT Objective: To characterize a chronic hepatitis B cohort based on initial and follow-up clinical evaluations. Methods: A retrospective and descriptive analysis of clinical and laboratory data from chronic HBsAg adult carriers, without HIV, unexposed to treatment, with at least two outpatient visits, between February 2006 and November 2012. Fisher´s exact test, χ², Wilcoxon, Spearman, multiple comparisons and Kappa tests were applied, the level of significance adopted was 5%, with a 95% confidence interval. Results: 175 patients with mean age of 42.95±12.53 years were included: 93 (53.1%) were men, 152 (86.9%) were negative for hepatitis B e-antigen (HBeAg), 3 (1.7%) had hepatitis C coinfection, 15 (8.6%) had cirrhosis, and 2 (1.1%) had hepatocellular carcinoma. Genotype A predominated. Sixty-six patients (37.7%) had active hepatitis, 6 (3.4%) presented immune tolerance, and 38 (21.7%) were inactive carriers. Exacerbations and/or viral breakthrough were detected in 16 patients (9.1%). In 32 patients (18.3%), hepatitis B virus DNA remained persistently elevated and alanine aminotransferase levels were normal, whereas in 17 (9.7%), there was low hepatitis B virus DNA and alterated alanine aminotransferase. If only initial alanine aminotransferase and hepatitis B virus DNA values were considered, 15 cases of active hepatitis would not have been detected. Advanced fibrosis was more common in HBeAg-positive patients, and it was significantly associated with transaminases, hepatitis B virus DNA, and age. Conclusion: Many patients had active hepatitis, but almost 25%, who were HBeAg non-reactive, were only identified because of combined analyses of the hepatitis B virus DNA and transaminases levels, sometimes associated with histological data, after clinical follow-up. |
| first_indexed | 2024-12-10T10:21:53Z |
| format | Article |
| id | doaj.art-15e7847aaa754a1bbaf9e900417c62a9 |
| institution | Directory Open Access Journal |
| issn | 2317-6385 |
| language | English |
| last_indexed | 2024-12-10T10:21:53Z |
| publisher | Instituto Israelita de Ensino e Pesquisa Albert Einstein |
| record_format | Article |
| series | Einstein (São Paulo) |
| spelling | doaj.art-15e7847aaa754a1bbaf9e900417c62a92022-12-22T01:52:50ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)2317-638513218919510.1590/S1679-45082015AO3269S1679-45082015000200004Characteristics of an outpatient chronic hepatitis B virus infection cohortDanyenne Rejane de AssisSimone de Barros TenoreJoão Renato Rebello PinhoDavid Salomão LewiPaulo Roberto Abrão FerreiraABSTRACT Objective: To characterize a chronic hepatitis B cohort based on initial and follow-up clinical evaluations. Methods: A retrospective and descriptive analysis of clinical and laboratory data from chronic HBsAg adult carriers, without HIV, unexposed to treatment, with at least two outpatient visits, between February 2006 and November 2012. Fisher´s exact test, χ², Wilcoxon, Spearman, multiple comparisons and Kappa tests were applied, the level of significance adopted was 5%, with a 95% confidence interval. Results: 175 patients with mean age of 42.95±12.53 years were included: 93 (53.1%) were men, 152 (86.9%) were negative for hepatitis B e-antigen (HBeAg), 3 (1.7%) had hepatitis C coinfection, 15 (8.6%) had cirrhosis, and 2 (1.1%) had hepatocellular carcinoma. Genotype A predominated. Sixty-six patients (37.7%) had active hepatitis, 6 (3.4%) presented immune tolerance, and 38 (21.7%) were inactive carriers. Exacerbations and/or viral breakthrough were detected in 16 patients (9.1%). In 32 patients (18.3%), hepatitis B virus DNA remained persistently elevated and alanine aminotransferase levels were normal, whereas in 17 (9.7%), there was low hepatitis B virus DNA and alterated alanine aminotransferase. If only initial alanine aminotransferase and hepatitis B virus DNA values were considered, 15 cases of active hepatitis would not have been detected. Advanced fibrosis was more common in HBeAg-positive patients, and it was significantly associated with transaminases, hepatitis B virus DNA, and age. Conclusion: Many patients had active hepatitis, but almost 25%, who were HBeAg non-reactive, were only identified because of combined analyses of the hepatitis B virus DNA and transaminases levels, sometimes associated with histological data, after clinical follow-up.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015000200004&lng=en&tlng=enHepatite B crônicaHepatite B/terapiaHistória naturalAntígenos E da hepatite B |
| spellingShingle | Danyenne Rejane de Assis Simone de Barros Tenore João Renato Rebello Pinho David Salomão Lewi Paulo Roberto Abrão Ferreira Characteristics of an outpatient chronic hepatitis B virus infection cohort Einstein (São Paulo) Hepatite B crônica Hepatite B/terapia História natural Antígenos E da hepatite B |
| title | Characteristics of an outpatient chronic hepatitis B virus infection cohort |
| title_full | Characteristics of an outpatient chronic hepatitis B virus infection cohort |
| title_fullStr | Characteristics of an outpatient chronic hepatitis B virus infection cohort |
| title_full_unstemmed | Characteristics of an outpatient chronic hepatitis B virus infection cohort |
| title_short | Characteristics of an outpatient chronic hepatitis B virus infection cohort |
| title_sort | characteristics of an outpatient chronic hepatitis b virus infection cohort |
| topic | Hepatite B crônica Hepatite B/terapia História natural Antígenos E da hepatite B |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015000200004&lng=en&tlng=en |
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