Peritoneoscopic Liver Biopsy Findings for Military Medical Certificate in Young Male Adults: Histologic Grading and Staging of Chronic Hepatitis

Paik, Yong Han; Chon, Chae Yoon; Park, Young Nyun; Han, Kwang Hyup; Moon, Young Myoung; Park, Chan Il

Abstract

BACKGROUND/AIMS: This study was designed to assess the etiology and characteristics of chronic liver disease among the young male adults. It was also investigated whether grades of activity and status of fibrosis defined by the new histopathologic classification system of chronic hepatitis are related with alanine aminotransferase (ALT) level and HBeAg status in HBsAg-positive case.
METHODS
Peritoneoscopic findings, clinical features and histopathologic features of liver were investigated for 140 young men who received liver biopsy for military medical certificate from January 1994 to December 1997. These features were evaluated according to the grade and stage of chronic hepatitis.
RESULTS
In Korea, hepatitis B virus was the main cause of chronic hepatitis (87.7%) in young male adults and the infection of hepatitis C virus was rare (1.4%). Among HBsAg-positive cases with normal ALT level, 82.2% of them revealed chronic liver disease, and 48.3% of them showed chronic active hepatitis/cirrhosis in biopsy specimens. The grade of chronic hepatitis showed weak correlation with ALT level and the stage did not. There was no significant difference in the grade and stage of chronic hepatitis according to the serum HBeAg status.
CONCLUSION
The most common cause of chronic liver disease in Korean young male adults was hepatitis B virus, and most (92.6%) of HBsAg-positive cases were proved to have chronic liver diseases histologically, regardless of the serum ALT level. According to new histopathologic classification system of chronic hepatitis, serum ALT level correlated with necroinflammatory activity of chronic hepatitis B, but not with fibrosis in HBsAg-positive cases.