Abstract
Objective To investigate the differences of hepatic pathology between the chronic hepatitis B (CHB) with pulmonary tuberculosis patients and CHB patients. Methods Seventy-nine treatment-naive patients with CHB complicated with pulmonary tuberculosis (co-infection group) were collected from January 2009 to December 2014, and 79 CHB patients were selected randomly during the same period as CHB group. Hepatic tissue inflammation and fibrosis between the two groups were compared according to Ishak scoring system. Comparison between two groups were conducted by t test when the variance was equal and Mann -Whitney U test when the variance was unequal. Categorical data were compared by χ2 test. Results A total of 59 (74.7%) patients in co-infection group had inflammation≥ G2, compared to 59.5% in the CHB group. The difference between the two groups was statistically significant (χ2=4.128, P=0.042). Forty-one (51.9%) patients in co-infection group had fibrosis≥S2, compared with 44.3% in the CHB group. The difference was not statistically significant (χ2=0.913, P=0.339). Ishak scoring system showed that piecemeal necrosis, portal area inflammation score and total score in co-infection group were all significantly higher than those in CHB group (2.45±1.19 vs 2.05±1.28, 2.70±1.22 vs 2.32±1.08, 13.16±6.51 vs 11.22±5.72, respectively) , with all the differences statistically significant (t=2.055, 2.068 and 1.984, respectively; P=0.042, 0.040 and 0.049, respectively). However, the confluent necrosis in co-infection group was 2.60±1.91 compared to 2.13±1.68 in CHB group (Z=1.137, P=0.257), focal (dot) soluble necrosis was 2.35±1.06 versus 2.16±0.86 (Z=-1.148, P=0.251), and fibrosis was 3.03±1.63 versus 2.45±1.53 (Z=1.541, P=0.125). Conclusion The liver damage in co-infection patients is more severe compared with CHB patients. Key words: Hepatitis B, chronic; Tuberculosis, pulmonary; Hepatitis B virus; Mycobacterium tuberculosis; Liver biopsy; Pathology
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