Role of Liver Biopsy in Patients With Chronic Hepatitis B Who did not Fulfill the Criteria for Immediate Treatment

Antoine Abou Rached, Jowana Saba, Tarek Haykal, Elie Tabcharani, Josiane Kerbage, Saad Khairallah


AIM: Lebanon is considered recently as a low endemic country for chronic Hepatitis B. The Aim of our study was to know the METAVIR score in patient with chronic hepatitis B and e negative Ag, who didn’t fulfill the local and international treatment criteria, who have HBVDNA > 2000 IU/mL, with normal or slightly elevated ALT level.

METHODS: We review all hepatic biopsies done during the last 4 years in patient with chronic Hepatitis B, HBeAg negative, HBV DNA> 2000IU/ml and ALT within normal range. Collected data were classified and distributed according to METAVIR scoring system for fibrosis and activity, then subdivided according to age, sex and all possible associations between inflammation and fibrosis.

RESULTS: A total of 248 liver biopsies were seen during this period, only 45 biopsies responded to inclusion criteria. The distribution of liver biopsies related to age show that 64% of patients were between 21 and 40 years old, there is a male predominance. The distribution of liver biopsies related to chronic hepatitis B according to the METAVIR score show that 28.86% had advanced fibrosis (stage F2 or more and/or activity A2 or more).

CONCLUSION: This study demonstrate the importance of liver biopsy in patients with chronic hepatitis B, HBeAg negative and show that 29% of this group of population need medical treatment for advanced liver disease.


Liver biopsy; ALT; HBeAg negative; Treatment indication

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