Gastroenterology, Hepatology & Digestive Disorders
Open AccessVirological and Histological Profiles of Chronic Hepatitis B Virus Carriers with Pre-core Mutations: A Cross-sectional Study in Four Hospitals in Douala, Cameroon
Authors: Eloumou Bagnaka Servais Albert Fiacre, Bekolo Nga Winnie Tatiana, Tchamna Frankline Aurelle, Bidjogo Epse Gwet Marina, Nsenga Djapa Guy Roger, Machekam Epse Matanga Olga, Noah Noah Dominique, Tzeuton Christian, Luma Namme Henry.
Abstract
Introduction: Chronic hepatitis B virus (CHB) infection is a major public health concern and a leading cause of cirrhosis and hepatocellular carcinoma (HCC). The aim of this study was to describe the virological and histological profiles of CHB virus carriers with pre-core mutations.
Methods: A cross-sectional study conducted in 4 hospitals in Douala for 10 years, from January 1st to December 31st. The study included patients diagnosed with CHB and who were HBeAg-negative. We excluded patients Co-infected with HDV, HCV, HIV and those already on treatment at the time of consultation. Data collected was sociodemographic, clinical, biological, histological and morphological variables. Liver fibrosis was assessed using transient elastography, FIB-4 and APRI score. The degree of fibrosis was separated into significant and nonsignificant fibrosis. Statistical analyses were performed using SPSS software version 26.0. Logistic regression by univariate then multivariate analysis were used to identify associated factors with significant fibrosis. A p–value <0.05 was considered statistically significant.
Results: A total of 1082 patients were included, with a mean age of 35.9±9.9 years. The male gender represented 59.3% (n=642). The main comorbidity was alcohol consumption 62.2% (n=659), and the dominant risk factor was unprotected sex 92% (n=977). The prevalence of pre-core mutations was 36.8% (N=1082/2937). ALAT was greater than normal in 19.2%(n=205) and ASAT greater than normal in 14.4% (n=153). High viral load was found in 30.2% (n=327) and low quantitative HBsAg was found in 77.1% (n=229) of the study population. The median of HBV DNA was 533IU/mL (IQR=95-3036) and that of quantitative HBsAg was 5160 IU/mL (IQR=1161-12515). On transient elastography, 17.7% (n=77) showed significant fibrosis. FIB-4 and APRI score showed 4.9% (n=49) and 6.3% (n=63) of patients with significant fibrosis respectively. Cirrhosis and HCC were present in 1.3% (n=14) and 0.2% (n=2) respectively. significant fibrosis on transient elastography was independently associated with the male gender (p=0.033, OR=1.954, 95% CI: 1.056-3.615) and ASAT greater than the normal value (P=0.027, OR=2.659, 95% CI:1.118 – 6.323).
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