Liver biopsy results of chronic HBV carriers aged above 40 years: an analysis of 442 cases

Objective To observe the histological changes of the liver in chronic HBV carriers aged above 40 years. Methods A total of442 chronic HBV carriers aged above 40 years who underwent liver biopsy in Hepatology Hospital of Jilin Province from August 2012 to August 2015 were enrolled. Liver tissue samples were collected from all patients using ultrasound-guided rapid puncture, and the proportion of patients with grade ≥G2S2 liver fibrosis or liver cirrhosis was calculated. The association of medical history of HBV infection, liver function, body mass index ( BMI) and Fibro Scan with histological changes of the liver was analyzed. The t-test was used for comparison of continuous data between groups, relative risk ( RR) was used to analyze risk factors, and a Kappa analysis was used for consistency test. Results Of all 442 chronic HBV carriers aged ≥40 years, 56. 56% had grade ≥G2S2 liver fibrosis and 20. 14% had liver cirrhosis. The length of the medical history of HBV infection and BMI were correlated with the degree of liver fibrosis, and medical history > 10 years ( OR= 64. 06, 95% CI: 33. 72-121. 69, P < 0. 001) and BMI ≥24 ( OR = 6. 93, 95% CI: 4. 64-10. 35, P < 0. 001) were risk factors for liver fibrosis and cirrhosis. There were significant differences between grade < G2S2 liver fibrosis patients and grade ≥G2S2 liver fibrosis patients in the levels of alanine aminotransferase, aspartate aminotransferase, adenosine deaminase, gamma-glutamyl transpeptidase, alkaline phosphatase, and prealbumin ( t = 40. 00, 2. 16, 25. 35, 47. 73, 12. 62, and 13. 38, all P < 0. 05) . The consistency analysis of Fibro Scan and liver biopsy in the diagnosis of liver cirrhosis showed a Kappa value of 0. 76, suggesting that there was a good diagnostic consistency between these two methods. Conclusion Monitoring and management of chronic HBV carriers aged above 40 years should be taken seriously in clinical practice, and liver biopsy should be performed as soon as possible for those with ALT > 30 U/L and marked liver fibrosis suggested by Fibro Scan.