Liver histology pattern of young patients with inactive chronic hepatitis b virus infection from a hospital in South West Nigeria

Background: Chronic hepatitis B (CHB) infection is the leading cause of chronic liver disease in sub-Saharan Africa. A significant proportion of patients with CHB are inactive carriers, for whom guidelines neither recommend biopsy nor treatment. In sub-Saharan Africa, patients under 30 years old with CHB sometimes develop liver cancer, raising the possibility that significant liver disease may occur early in life in these patients.

Methods: A hospital-based cross-sectional study was conducted on patients with inactive CHB. A convenient sampling method was used to recruit patients. All patients underwent a percutaneous liver biopsy to evaluate significant necroinflammation and fibrosis using the Meta-analysis of histological data in viral hepatitis (METAVIR) system, defined as at least METAVIR A2, F2 disease. Tests of association between the histological outcomes, sociodemographic factors, and laboratory findings were performed. The data obtained were entered into the Statistical Package for the Social Sciences (SPSS) version 21 and analysed using descriptive and inferential statistics. A p-value of < 0.05 was considered statistically significant.

Results: A total of 88 patients-60 males (68.2%) and 28 females (31.8%)-completed the study. The study participants were aged 18 to 29 years, with a mean age of 25.4 ± 3.4 years. Thirty-nine (44.3%) had significant necroinflammation and/or fibrosis on histology, 19 (21.6%) of whom had necroinflammation only, and 13 (14.8%) had both necroinflammation and fibrosis. Males had significant necroinflammation and fibrosis more than the females. A family history of death from liver disease was associated with significant liver fibrosis (p < 0.05).

Conclusion: A portion of young patients with inactive CHB have significant liver disease, particularly those with a family history of liver-related death. Liver biopsy may therefore be beneficial in these categories of patients to detect this.