Diagnóstico histológico de la hepatitis viral crónica B

Actualmente existen alrededor de 350 millones de personas con hepatitis cronica B en el mundo, esta es causa frecuente de la hepatitis cronica, cirrosis hepatica y carcinoma hepatocelular. Objetivos: caracterizar las alteraciones histopatologicas de hepatitis B cronica en el Hospital General Docente "Abel Santamaria Cuadrado" desde enero de 2002 hasta diciembre de 2009. Diseno: se estudiaron las biopsias con el diagnostico de hepatitis viral cronica mediante un diseno retrospectivo y transversal. Metodo: universo: 259 biopsias diagnosticadas como hepatitis viral cronica. Muestra: 126 biopsias diagnosticadas como hepatitis B cronica. Se determinaron la edad, el sexo, lesion histologica y correspondencia diagnostica entre grado de lesion histologica y estadio de fibrosis con la edad. Se uso la estadistica descriptiva para resumir las variables categoricas y cuantitativas, calculos de comprobacion de frecuencias y/o asociaciones de variables X², OR. Resultados: se elaboraron dibujos histologicos representativos de la clasificacion de hepatitis viral cronica (Ishak, 1995). La hepatitis B cronica se diagnostico mas en los hombres de 35 a 44 anos en el periodo estudiado. En todos los parametros de necrosis e inflamacion fue mas frecuente el de 1 punto, predomino la actividad necroinflamatoria minima que alcanzo el 34,9 %. Se observo mas la fibrosis ligera. Conclusion: se comprobo que el sistema de dibujos posibilita mejor estandarizacion del diagnostico en un colectivo. La hepatitis B cronica fue mas frecuente entre 35-44 anos, sexo masculino, con un predominio de la actividad necroinflamatoria minima y fibrosis ligera.(AU) Nowadays 350 millions of people suffer from chronic hepatitis B all over the world; this is a frequent cause of chronic hepatitis, hepatic cirrhosis and hepatocellular carcinoma. Objective: to characterize the histopathological alterations of chronic hepatitis B at "Abel Santamaria Cuadrado" University Hospital from January 2002 to December 2009. Design: biopsies having the diagnosis of chronic viral hepatitis by means of a retrospective and cross-sectional design were analyzed. Method: the target group included 259 biopsies with the diagnosis of chronic viral hepatitis and the sample contained 126 biopsies with the diagnosis of chronic hepatitis B. Age, sex, histological lesion and in correspondence with the diagnosis between the histological degree of the lesion and fibrosis stage according to the age. Descriptive statistics was used to sum up categorical and quantitative variables as well as calculations to confirm frequencies and/or associations of variables X² and odds ratio (OR). Results: representative histological draws for the classification of chronic viral hepatitis were created (Ishak, 1995). Chronic hepatitis B was mainly diagnosed in men (35-44 years old) during the period studied. In all the parameters analyzed of necrosis and inflammation, that one of the point 1 was the most frequent, minimal necrotic-inflammatory activity reached 34, 9%. Mild fibrosis was highly observed. Conclusions: it was confirmed that the system of draws makes possible a better standardization of the diagnosis in a group. Chronic hepatitis B was more frequent between 35-44 years old, prevailing minimal necrotic-inflammatory activity and mild fibrosis.(AU)