Hepatic fibrosis among chronic hepatitis B virus-infected patients: North-Western Nigeria experience

Abstract

Abstract Background: Chronic hepatitis B (CHB) virus infection is a global health problem, affecting two billion individuals worldwide, with 257 million suffering from chronic infection. This condition can lead to severe complications, including fulminant hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). Fibrosis serves as the common pathway through which CHB infection progresses to cirrhosis and HCC. Liver biopsy is considered the gold standard assessment method, although it is a procedure that is often avoided. However, the feared complications associated with it can be averted with preventive measures. In this study, we aim to assess the fibrosis pattern among CHB patients using liver biopsy, as well as its tolerability and histological outcome within our locality. Materials and Methods: This was a cross-sectional descriptive study conducted at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Sixty-eight patients with CHB infection were consecutively recruited over a period of 7 months. Following a focused history and physical examination, various tests including complete blood count, liver enzymes, serum proteins, prothrombin time, and international normalized ratio were conducted. A liver biopsy was performed on all eligible consenting subjects without contraindications. The histological findings and results of investigations were recorded and analyzed accordingly. Results: The mean age of the study subjects was 32.43 ± 10.50 years with a male-to-female ratio of 2:1. More than 80% of the patients were negative for HBe antigen (envelope antigen). Out of the 68 patients successfully biopsied, 42 (61.7%) had histological evidence of necroinflammation, with 22% exhibiting significant inflammation. Additionally, 35 patients (56.5%) displayed evidence of fibrosis, with 46.5% of them having significant fibrosis. Conclusion: More than half of the CHB patients examined exhibited evidence of fibrosis and necroinflammation.