Munkhbat, Batmunkh

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Measurement of Liver Fibrosis in Chronic Hepatitis D: Comparison of Invasive and Non-Invasive Methods
(Mongolian National University of Medical Sciences, 2019-03-31)
Gidaagaya, Sarantuya
;
Dorj, Sumiya
;
Jamsranjav, Selenge
;
Dungubat, Erdenetsogt
;
Batmunkh, Munkhhbat
Objectives: The aim of this study was to compare non-invasive methods in the detection of hepatic fibrosis in patients with chronic hepatitis delta. Methods: Twelve patients with chronic hepatitis delta who visited the Gastroenterology Department at the Intermed Hospital, were studied. Clinical and histological data were evaluated and serum indirect fibrosis markers including AST to ALT ratio, AST-to-Platelet Ratio, Fibrosis-4 index scores were calculated. Serum Mac-2 binding protein glycosylation isomer and liver stiffness measurements were performed in all participants. Results: Histological scoring showed that 16.7%, 41.7% and 41.7% of participants had F2, F3, and F4 stage of liver fibrosis, respectively. All participants were divided into groups; cirrhotic (F4) and non-cirrhotic (F0-F3). The median AST to ALT ratio in cirrhotic vs. noncirrhotic patients was 1.4 vs. 1.1 (p=.67), AST-to-Platelet ratios were 0.7 vs. 1.1 (p=.48), and Fibrosis-4 index scores were 1.8 vs. 1.6 (p=.82) in non-cirrhotic patients. Median Mac-2 binding protein glycosylation isomer levels in the cirrhotic group 1.3 cut-off index vs. 1.4 cut-off index in the non-cirrhotic group (p=.85). The median liver stiffness was 12.6 kPa in cirrhotic patients while 8.1 kPa in non-cirrhotic patients (p=.05). Conclusion: Non-invasive serum markers were less accurate in determining fibrosis in chronic hepatitis delta patients. Liver stiffness measurement was superior to the non-invasive serum markers.
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Prevalence, characteristics, and virologic correlations of hepatitis delta (D) among patients with hepatitis B surface antigen in Mongolia
(National Center for Global Health and Medicine (JST), 2024-04)
Gidaagaya, Sarantuya
;
Rokuhara, Akinori
;
Sugiyama, Masaya
;
Dorj, Sumiya
;
Barsuren, Batnasan
Clinical and biochemical features of hepatitis delta virus (HDV) infections in Mongolia remain largely unknown. We aimed to investigate the clinical characteristics of HDV patients in Mongolia using several markers. The 143 hepatitis B surface antigen (HBsAg)-positive patients were divided into 122 HDV-positive and 21 HDV-negative patients by HDV RNA positivity. Subgroup analysis was performed between hepatitis B e antigen (HBeAg)-positive and -negative HDV-positive patients. Liver function, quantitative HBsAg (qHBsAg), anti-HDV Immunoglobulin (Ig) M, Mac-2 binding protein glycosylation isomer (M2BPGi), hepatitis B virus (HBV) DNA level, and HDV RNA level were tested. HDV RNA was positive in 85.3% (122/143) of patients showing anti-HDV IgG. Liver disease activity was higher in HDV-positive patients than in HDV-negative patients. The HDV-positive group included a higher proportion of patients with high qHBsAg and M2BPGi levels (p < 0.001). The positivity rate for anti-HDV IgM was significantly higher in the HDV-positive group (p < 0.001). HDV RNA levels showed an inverse correlation with qHBsAg levels in HBeAg-positive-HDV-positive patients (r = -0.49, p = 0.034), and a positive correlation with qHBsAg levels in HBeAg-negative patients (r = 0.35, p < 0.001). Hepatitis B virus (HBV) DNA and HDV RNA levels did not show any correlation. M2BPGi levels likewise did not correlate with HDV RNA levels. A high positivity rate for HDV RNA was observed for HBV patients in Mongolia using the highly sensitive HDV RNA assay. The positivity rate for anti-HDV IgM was high in HDV RNA-positive patients. Severity of liver disease and M2BPGi levels were both high in the HDV RNA-positive group.
Scopus© Citations 2

Munkhbat, Batmunkh

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