Clinical and Virological Features of Acute Hepatic Exacerbations in Patients With Chronic Hepatitis B Virus Infection

摘要

Background and aim: In this study, we aimed to perform a comprehensive analysis of patients with acute hepatic flares observed during the course of chronic hepatitis B infection in order to provide early diagnosis, management, and best characterization of this unique group of hepatitis B patients. Patients and methods: The study was designed in a retrospective and prospective manner. Chronic hepatitis B patients with acute hepatic flares, admitted to the Department of Gastroenterology and Hepatology were enrolled in the study. Demographic,?clinical, biochemical, and virological?findings?were recorded via pre-prepared forms. Results:?The study was conducted on 125 patients. The mean age was?34.08?±?12.68?and the male?to female ratio was determined as 2.28. Over 117?patients?(93.6%)?had?at least one symptom.?The most common symptoms and signs were fatigue?(81.6%),?anorexia (64%), jaundice (60%), and?nausea?(52%). Anti-HBc?immunoglobulin M (IgM) antibody?was detected in 24?patients?(19.2%) and serum hepatitis B virus (HBV) deoxyribonucleic acid (DNA) was positive in 107 (85.6%) patients.?The most common cause?of exacerbations was spontaneous?hepatic?flares?(80.8%). Conclusion: According to the results?of this single-center study,?acute?hepatic exacerbations are more common?in young men. The disease usually presents?with non-specific symptoms?and jaundice?is the most common?finding. As a sign of?intensive inflammation and hepatocellular injury, serum ferritin levels seem to be high. Serum?HBV DNA and?anti-HBc?IgM positivity with elevated alpha-fetoprotein (AFP) levels?are presenting?features?of acute?hepatic exacerbations.