Analysing Liver Histology in Relation to Elevated HBV DNA Levels in Immuno-Tolerant Phase of Chronic Hepatitis B Viral Infection Patients

<i>Introduction</i>: Chronic Hepatitis B viral infection is associated with significant health and financial challenges. An estimated 15-40% of the Chronic Hepatitis B infected patients would develop liver Cirrhosis and a quarter of which may result in Hepatocellular cancer. In Africa, about 65 million people are said to be chronically infected with HBV. Thus, Africa with 12% of the world’s population carries approximately 18% of the global burden of HBV infection. An elevated level of ALT is an important component in the consideration for treatment of CHB, however, the presence of normal level ALT levels with discordantly elevated HBV DNA levels may requires further evaluation with Liver histology. <i>Method</i>: All patients who were newly diagnosed with CHB infection and above 18 years of age were consecutively recruited from December 2019 to October 2020, into the study. Blood samples were taken for the Liver Function Test, HBV immunologic panel and HBV DNA levels. Liver biopsy was performed for 84 patients with variance elevated serum HBV DNA (>2000 IU/mls) and normal serum ALT defined as level <40 Unit/mls. The Data collected was entered and analyzed using the SPSS version 20. The clinical profiles and HBV DNA level of the respondents were presented using mean and standard deviation while frequencies, percentages and charts was used to summarize qualitative variables. Chi-square test and Fisher’s exact test were used to analyze factors associated with respondent’s HBeAg status and liver histology. <i>Result</i>: The Liver biopsy histology shows, mild inflammation (A1) was observed in 50 (60%), and moderate inflammation (A2) in 12% while the remaining 10 patients (28%) showed no inflammatory. Similarly, 20 patients (24%) had no fibrosis (F0), 8% had portal fibrosis without septa (F1), 24% had portal fibrosis with rare septa (F2) while the remaining majority (44%) had numerous septa (F3). <i>Conclusion</i>: Chronic HBV infection is Endemic in our region and studies had shown the importance of adequate evaluation and early treatment to avert the associated high morbidity and mortality. Also, significant number of patients with normal ALT levels had fibrosis on liver histology. Liver histology remains an important parameter in the evaluation of patients with CHB, as 57 patients would have missed the opportunity of early treatment. These findings are expected to provide a basis for an informed planning of national and International CHBV treatment guidelines.