Background: Fibrosis is the most important predictor of prognosis in patients with Chronic hepatitis B (CHB) related liver disease. Detecting early fibrosis is vital to reduce complications of CHB like cirrhosis and HCC. High viral load is an important predictor of fibrosis. There are many studies reporting the association of hepatitis B (HBV) viral load with degree of liver fibrosis, but results are inconsistent. Hence, this study was undertaken to assess the relationship of HBV DNA titre with liver fibrosis.
Methods: We recruited all newly detected treatment naive CHB patients between May 2021 to January 2023 at Department of Hepatology SCB medical college Cuttack. HBVDNA quantification and fibrosis assessment using 2D shear wave elastography (SWE) were done. The primary endpoint was the relation between HBVviral load and liver fibrosis stage and the estimation of HBV DNA cut off levels for advanced fibrosis =F3.
Results: Ninety-eight patients were enrolled (mean age: 46.05±13.21 years, male to female ratio-2.76:1). HBV DNA levels were higher in patients with advanced fibrosis LSM =8kpa (F3) although the difference was statistically not significant (P=0.6). HBV DNA levels were also higher in CHB patients with significant fibrosis than those with less degree of fibrosis, in both HBeAg positive and HbeAg negative individuals, although this difference did not achieve statistical significance (p=0.655 and p=0.685). Age, serum albumin, serum ALT levels, total platelet count, CTP score and MELD-Na score were significant predictors of fibrosis on univariate analysis. But on multivariate analysis, platelet count (OR=0.999, CI=0.981-0.997, p=0.006) and MELD-Na score (OR=1.064, CI=1.01-1.198, p=0.024) were independent predictors of liver stiffness. A cut off HBV DNA of 17500 (IU/ML) with sensitivity of 51 % and specificity of 41% had a poor diagnostic accuracy to predict F3 fibrosis.
Conclusion: There was no significant correlation between HBV DNA levels and stage of liver fibrosis.