RESULTS OF ULTRASOUND ELASTOMETRY OF THE LIVER IN INDIVIDUALS WITH CHRONIC VIRAL HEPATITIS B (BASED ON HOSPITAL ATTENDANCE REGISTER DATA IN AZERBAIJAN)

Abstract

The aim of this study is to identify the frequency and severity of liver damage using ultrasound elastometry in chronic viral hepatitis B (HBV) among the population of different regions of Azerbaijan. Objects and methods. The study involved patients residing in Baku, Sumgait and certain regions of Azerbaijan and seeking medical care at the Medical Centre “Medikus clinic“ in Baku. There were examined 639 participants with HBV, 398 men and 241 women. They were divided into 5 age groups: 1st group included individuals aged from 18 to 29, 2nd group involved patients aged 30-39, 3rd group included patients aged 40-49, 4th group was formed by 50-59 year old patients and 5th group included individuals of 60 years and older. In order to verify the HBV diagnoses, specific laboratory investigation methods and their evaluation criteria were applied. The study was carried out by ELISA using the Access 2 Immunoassay System (Beckman Coulter). The participants were diagnosed as B hepatitis positive, when their indicator equalled to 5 IU/ml. The study was conducted on by applying the “Rotor Gene Q“(Germany). Elastometry was performed by using 2D – Supersonic Aixplorer SWE (France).The examination was carried out according to the Cut–offs scale, and liver fibrosis was determined according to the METAVIR scale (sensitivity of the method is more than 80%, specificity is more than 90%). The level of hepatic tissue density was estimated in cRa. The density value of more than 5 kPa was regarded as pathological. Ultrasound elastometry of the liver will enable to assess the intensity of its fibrosis and predict its possible complications, which, along with other preventive measures, will significantly reduce disability and mortality. Results. The data on the liver elastometry indicators of men and women with confirmed diagnosis of chronic HBV, regardless of their region of residence are presented. In male patients, there is an obvious reliable association between an increase in the stiffness of the liver tissue and an increase in the age of the individuals (1 - 5.3±0.4 kPa; 2 – 5.4±0.2; 3 – 6.3±0.6; 4 – 8.2±0.8; 5 – 10.8±0.8 (p<0.001)). Among women under 50 years, the hepatic tissue stiffness index values corresponded the normal ones (less than 5 kPa), and then significantly increased, then in the last age group it decreased unreliably (1 – 4.4±0.2; 2 – 4.2±0.1; 3 – 4.2±0.1; 4 – 9.7±1.4 (p<0.001); 5 – 8.3±1.2). Comparing the results obtained, it can be stated that in males with HBV, gender and age play a significant role in the development of liver fibrosis. In all age groups, this indicator was higher than the standard. Among women under the age of 50, the process does not develop, but it sharply picked up the growth rate after 50 years, and then stabilized. In men, the discussed indicator was higher compared to women. Conclusion. Chronic HBV has a significant negative effect on the indicator of assessing the degree of development of fibrous tissue. The age of 50 years in patients with chronic HBV is an important factor, which in many cases, without gender differences, significantly increases the rate of formation of fibrous tissue in the liver.