Relationship of HBeAg Status with ALT DNA Level and Liver Histology in Chronic Hepatitis B Patients

Objective: Chronic hepatitis B (CHB) infection is a highly prevalent and important health problem. Hepatitis B virus (HBV) infection is a very important public health problem in our country. Our country is in a mid-hepatitis B virus-endemic area. Hepatitis B virus (HBV) is enveloped DNA virus which causes acute and chronic infections. Liver biopsy is the gold standard procedure for documenting liver damage in chronic hepatitis. In this study, our aim was to determine the relationship of positive or negative HBeAg status in chronic hepatitis B patients with ALT (alanine aminotransferase), DNA level and liver histology. Materials and Methods: We retrospectively evaluated medical records of 230 hepatitis B patients who underwent liver biopsy in our clinic. Demographic properties, biopsy results, liver enzymes, HBV DNA levels and serological indications were evaluated. HBV DNA was investigated by quantitation of DNA using realtime polymerase chain reaction (PCR) and serological markers by enzyme immunoassay (EIA). Patients were separated into 2 groups according to their HBeAg status (group 1= HBeAg-positive; group 2= HBeAg-negative). Results: Two hundred and thirty patients participated in the study. The average age of patients in group 1 and group 2 was 36.42 +/- 11.76 and 47.01 +/- 12.15, respectively. There was a statistically significant difference in average age between the groups (p<0.000). The average ALT level was higher in HBeAg-positive group (p<0.000). There was no significant difference in fibrosis score between the groups, however, histologic activity index (HAI) was higher in group 2 than in group 1. When the correlation between ALT and HAI was evaluated, a significant and positive correlation was found only in HBeAg negative-patients while no significant correlation could be detected between ALT and fibrosis in both groups. There was not any significant correlation between DNA and fibrosis in group 1 while positive correlation was detected in group 2. Conclusion: We assume that when evaluating HBV infections, serological tests, HBV DNA level, liver enzymes, previous treatments and clinical status of the patient should be considered as a whole.