P-126 PREVALENCE OF LIVER FIBROSIS IN THE INFECTION BY THE HEPATITIS B AND C VIRUS IN GUATEMALA

Introduction and Objectives

It is known that patients with chronic hepatitis C virus (HCV) and hepatitis B virus (HBV) infection develop early fibrosis in the first five years of infection. The evaluation of liver fibrosis is currently reliable by noninvasive methods such as transient vibration-controlled elastography (VCTE), the Fibrosis Index 4 (FIB-4) and the Aspartate Aminotransferase-Platelet Ratio Index (APRI). In Guatemala in 2015, HCV was the main cause of chronic hepatitis, cirrhosis and liver cancer. Despite this, there are few studies on the prevalence of fibrosis in these patients. This study aimed to determine the prevalence of liver fibrosis by non-invasive methods in patients with chronic HBV and chronic HCV infection.

Materials and Methods

A retrospective descriptive study including patients registered in the Unit for HIV and Chronic Infections of the Hospital Roosevelt in Guatemala during the period from January 2015 to December 2020. Patients between 18 and 80 years of age were included. The non-invasive methods used were the FIB-4 index, APRI and VCTE.

Results

229 patients were included, 175 with HCV infection and 54 with HBV; 50.6% were male with an average age of 56 years. 54.2% of the patients identified with fibrosis were made by the VCTE method and 45.8% by the APRI and FIB-4 methods. 48.4% of the patients with fibrosis were F4, the most frequent grade of fibrosis was F4, followed by F3 in HCV and F1 in HBV. Most of the patients with fibrosis (55%) were six months to 2 years after diagnosis of the infection. The most frequent clinical manifestation was esophageal varices (15.5%), ascites (5.0%) and upper gastrointestinal bleeding (2.9%)

Conclusions

There is a high prevalence of liver fibrosis and advanced fibrosis in patients with chronic infection by hepatitis B and C viruses in Guatemala, mainly in the first two years of diagnosis.