Abstract:

Introduction

The course of HBV infection is influenced by many factors. Various guidelines have recommended liver biopsy in different groups of CHB patients.

Aim

The aim of our study was to evaluate the histomorphological findings in Bulgarian patients with chronic HBV infection.

Materials and methods

A total of 335 patients with chronic HBV infection were evaluated. Two hundred and thirty one patients had liver biopsies and the remaining 104 patients were with liver cirrhosis. The grades of activity and stages of fibrosis were scored according to METAVIR

Results

The proportion of the patients with mild activity grade (40.7%) was the highest. Regarding the fibrosis stages, the proportions of cases with mild and moderate stages of fibrosis were similar (32.5% and 31.6%, respectively) and higher compared to those of cases with advanced fibrosis stages (22.1% and 13.9 for F3 and F4 stages, respectively). There was a trend for an increase of the mean age of patients from the subgroups with mild to severe activity grades. The mean age of the patients with LC was significantly higher compared to that of the subgroups of patients with different activity grades, respectively (p= 0.001). There were significant differences between the mean ages of patients with F1, F2 or F3 stages and those of patients with F4 and LC (p=0.015-0.0001). No sex difference was found in the comparison of the mean ages of the patients with the individual grades of activity or stages of fibrosis.

Conclusion

About 30 percent of Bulgarian patients with CHB are cirrhotic before starting antiviral therapy and 10 years older compared to the non-LC CHB patients. Almost three quarters of all patients with CHB were males. Severe histomorphological activity was found in only 1/5 of the patients with CHB and advanced fibrosis in 1/3 of them. There was a trend for an increase of the mean age of patients with CHB from the subgroups with mild to severe activity grade and from F1 to F4 stage, respectively.