AIM: To assess an early termination of immune toler-ance state of chronic hepatitis B virus infection in Ban-gladesh and its clinical significance. METHODS: From a series of 167 treatment-naive chronic hepatitis B pat...AIM: To assess an early termination of immune toler-ance state of chronic hepatitis B virus infection in Ban-gladesh and its clinical significance. METHODS: From a series of 167 treatment-naive chronic hepatitis B patients aged between 12 to 20 years(mean ± SD; 17.5 ± 2.8 years), percutaneous liver biopsies of 89 patients who were all hepatitis B e antigen negative at presentation were done. Of them, 81 were included in the study. They had persistently normal or raised serum alanine aminotransferase(ALT) values. A precore mutation(PCM) study was accom-plished in 8 patients who were randomly selected. RESULTS: Forty-four(53.7%) patients had significant necroinflammation(HAI-NI > 7), while significant fi-brosis(HAI-F ≥ 3) was seen in 15(18.5%) patients. Serum ALT(cut off 42 U/L) was raised in 29(35.8%) patients, while low HBV DNA load(< 105 copies/mL)was observed in 57(70.4%) patients. PCM was nega-tive in all 8 patients. CONCLUSION: This study indicates that the current concept of age-related immune tolerance state of HBV infection deserves further analyses in different popula-tion groups.展开更多
文摘AIM: To assess an early termination of immune toler-ance state of chronic hepatitis B virus infection in Ban-gladesh and its clinical significance. METHODS: From a series of 167 treatment-naive chronic hepatitis B patients aged between 12 to 20 years(mean ± SD; 17.5 ± 2.8 years), percutaneous liver biopsies of 89 patients who were all hepatitis B e antigen negative at presentation were done. Of them, 81 were included in the study. They had persistently normal or raised serum alanine aminotransferase(ALT) values. A precore mutation(PCM) study was accom-plished in 8 patients who were randomly selected. RESULTS: Forty-four(53.7%) patients had significant necroinflammation(HAI-NI > 7), while significant fi-brosis(HAI-F ≥ 3) was seen in 15(18.5%) patients. Serum ALT(cut off 42 U/L) was raised in 29(35.8%) patients, while low HBV DNA load(< 105 copies/mL)was observed in 57(70.4%) patients. PCM was nega-tive in all 8 patients. CONCLUSION: This study indicates that the current concept of age-related immune tolerance state of HBV infection deserves further analyses in different popula-tion groups.