Effect of viral load on hepatic fibrosis in patients with chronic hepatitis B patients: assessed by fibroscan

Abstract

Background: Hepatitis B virus (HBV) infection is a severe worldwide health problem and a primary cause of chronic hepatitis, hepatic fibrosis, cirrhosis, and hepatocellular cancer. In Egypt, the prevalence of HBsAg is of intermediate endemicity (2–8%). It has been known that the viral load and degree of hepatic fibrosis are considered independent factors that predict clinical outcomes after persistent HBV infection. However, the exact relationship between viral load and hepatic fibrosis is not well studied. Objectives: Our objective was to investigate the clinical effects of viral load on the severity of hepatic fibrosis. Patients and methods: Sixty patients with evident chronic HBV infection were enrolled. Using transient elastography, the patients were divided into two groups. Group 1: low fibrosis stage F1–2, and Group 2: high or significant fibrosis stage (F3–F4). Both groups were statistically compared for HBV-DNA viremia (PCR), clinical, and laboratory tests. Results: Serum bilirubin (p = 0.048), international normalised ratio (p 0.0001), and albumin (p = 0.01) were significantly increased in patients with higher grades of liver fibrosis on top of CHB. In addition, the viral load was found to be considerably greater in individuals who had higher grades of liver fibrosis and cirrhosis (P = 0.03). Conclusions: During follow-up, an obvious increase in the viraemia level may indicate significant hepatic fibrosis in patients with chronic HBV infection. Our results could influence the decision about liver biopsy or treatment at that point.

Keywords

• viral load hepatitis b transient elastography liver stiffness