Yağlı karaciğeri olan hastalarda Hepatit B belirteçlerinin karaciğer fibrozisi üzerindeki etkisinin farklı skorlama sistemleri ile değerlendirilmesi
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Tarih
2025
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Yayıncı
Alanya Alaaddin Keykubat Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Giriş: Yağlı karaciğer hastalığı ve kronik hepatit B (HBV) enfeksiyonu karaciğer fibrozisi gelişimi açısından bağımsız risk faktörleri olarak tanımlanmıştır. Ancak bu iki patolojinin eş zamanlı varlığının fibrozis progresyonuna etkisi net değildir ve sonuçlar çelişkilidir. Bu çalışmanın amacı, karaciğer yağlanması olan bireylerde hepatit B virüsü (HBV) ile karşılaşma durumuna göre oluşturulan serolojik gruplar arasında karaciğer fibrozisinin non-invaziv skorlama sistemleri ile karşılaştırmalı olarak değerlendirilmesidir. Gerekçe ve Yöntem: Retrospektif olarak planlanan bu çalışmaya, karaciğer yağlanması saptanan 286 hasta dahil edilmiştir. HBV ile hiç karşılaşmamış bireyler, HBsAg pozitif taşıyıcılar, HBV geçirmiş immün hastalar (anti-HBs ve anti-HBc pozitif) ile izole anti-HBc pozitif hastalar şeklinde dört gruba ayrılmıştır. Her bir hastanın demografik, klinik ve biyokimyasal verileri ile birlikte FIB-4, APRI, GPR ve NAFLD Fibrosis Skoru (NFS) hesaplanmış; serolojik gruplar arasında fibrozis skorları karşılaştırılmıştır. Bulgular: Fibrozis skorları gruplar arasında anlamlı farklılık göstermiştir. FIB-4 ve NFS skorları en yüksek İzole Anti-HBc pozitif grupta, APRI ve GPR skorları ise en yüksek HBV taşıyıcısı grupta saptanmıştır. (p<0,01) HBV ile hiç karşılaşmamış ve geçirmiş immün bireylerin fibrozis skorlarının daha düşük olduğu görülmüştür. Tüm gruplarda yapılan korelasyon analizlerinde FIB-4 ile APRI ve NFS arasında %62-74 arasında orta- güçlü, FIB4- GPR arasında %54-24 arasında orta-düşük düzeyde korelasyon saptanmıştır. Sonuç: Hepatit B taşıyıcılığı ve okkült HBV enfeksiyonu, yağlı karaciğer hastalarında fibrozis riskini artırabilir ve bu hasta grubunda daha dikkatli bir klinik yaklaşım gerekebilir. Non-invaziv skorların birlikte kullanımı, klinik karar sürecini destekleyebilir. Bulguların, biyopsi gibi altın standart yöntemlerle doğrulandığı ileri çalışmalara ihtiyaç vardır. Anahtar kelimeler: Steatotik karaciğer hastalığı, Hepatit B virüsü, Karaciğer fibrozisi
Introduction: Fatty liver disease and chronic hepatitis B (HBV) infection have been defined as independent risk factors for liver fibrosis. However, the impact of the coexistence of these two pathologies on fibrosis progression remains unclear, and findings in the literature are conflicting. The aim of this study was to comparatively evaluate liver fibrosis among different hepatitis B serological groups, categorized based on prior HBV exposure, using non-invasive fibrosis scoring systems in individuals with hepatic steatosis. Materials and Methods: This retrospective study included 286 patients diagnosed with hepatic steatosis, who were divided into four groups based on HBV serological markers: individuals with no prior exposure to HBV, HBsAg-positive carriers, those with resolved infection (anti-HBs and anti-HBc positive), and those with isolated anti-HBc positivity. Demographic, clinical, and biochemical data were collected, FIB-4, APRI, GPR, and NAFLD Fibrosis Score (NFS) were calculated for each patient. Fibrosis scores were compared between groups. Results: Fibrosis scores showed statistically significant differences between the groups. FIB-4 and NFS scores were highest in the isolated anti-HBc positive group, whereas APRI and GPR scores were highest in the HBsAg carrier group (p<0.01). Lower fibrosis levels were observed in individuals who had never been exposed to HBV and in those with resolved (immune) HBV infection. In correlation analyses a moderate-to-strong correlation was found between FIB-4 and both APRI and NFS scores (r = 0.62–0.74), while a moderate-to-weak correlation was observed between FIB-4 and GPR (r = 0.24–0.54). Conclusion: Hepatitis B carriage and occult HBV infection may increase the risk of fibrosis in patients with fatty liver, and a more careful clinical approach may be necessary in these patient groups. The combined use of non-invasive scores can support clinical decision-making. Further studies confirming the findings with gold standard methods such as liver biopsy are needed. Keywords: Steatotic liver disease, Hepatitis B virus, Liver fibrosis
Introduction: Fatty liver disease and chronic hepatitis B (HBV) infection have been defined as independent risk factors for liver fibrosis. However, the impact of the coexistence of these two pathologies on fibrosis progression remains unclear, and findings in the literature are conflicting. The aim of this study was to comparatively evaluate liver fibrosis among different hepatitis B serological groups, categorized based on prior HBV exposure, using non-invasive fibrosis scoring systems in individuals with hepatic steatosis. Materials and Methods: This retrospective study included 286 patients diagnosed with hepatic steatosis, who were divided into four groups based on HBV serological markers: individuals with no prior exposure to HBV, HBsAg-positive carriers, those with resolved infection (anti-HBs and anti-HBc positive), and those with isolated anti-HBc positivity. Demographic, clinical, and biochemical data were collected, FIB-4, APRI, GPR, and NAFLD Fibrosis Score (NFS) were calculated for each patient. Fibrosis scores were compared between groups. Results: Fibrosis scores showed statistically significant differences between the groups. FIB-4 and NFS scores were highest in the isolated anti-HBc positive group, whereas APRI and GPR scores were highest in the HBsAg carrier group (p<0.01). Lower fibrosis levels were observed in individuals who had never been exposed to HBV and in those with resolved (immune) HBV infection. In correlation analyses a moderate-to-strong correlation was found between FIB-4 and both APRI and NFS scores (r = 0.62–0.74), while a moderate-to-weak correlation was observed between FIB-4 and GPR (r = 0.24–0.54). Conclusion: Hepatitis B carriage and occult HBV infection may increase the risk of fibrosis in patients with fatty liver, and a more careful clinical approach may be necessary in these patient groups. The combined use of non-invasive scores can support clinical decision-making. Further studies confirming the findings with gold standard methods such as liver biopsy are needed. Keywords: Steatotic liver disease, Hepatitis B virus, Liver fibrosis
Açıklama
11.02.2026 tarihine kadar kullanımı yazar tarafından kısıtlanmıştır.
Anahtar Kelimeler
Gastroenteroloji, Gastroenterology, İç Hastalıkları
