3.2 Features related to acute or chronic liver disease in HBV-infected blood donors
Overall, of the 104 HBV-positive donors, 21 (20.2%) had acute liver disease and 83 (79.8%) had chronic liver disease based on AST/ALT ratio, with a mean AST of 59.7±56.6 U/L and ALT of 34.0±34.7 U/L. The mean age of donors indicative of chronic liver disease (28.6±7.51 years old) was lower compared to donors with suspicion of acute liver disease (31.8±9.53 years old), although no statistical significance was observed (p=0.097). Mean values of AST (41.7 to 68.2 U/L, p=0.706) and ALT (27.7 to 49.1 U/L, p=0.240) increased with age from under 20 to over 40 years, respectively. The chronic liver infection rate was highest in the 20-40 age group (85.5%, 71/83), being the same group that presented 1.97 times (95% CI: 0.54 – 7.21, p=0.305) more likely to develop chronic liver disease, compared to the other groups. Suspected liver disease in the acute (90.5%, 19/21) or chronic (85.5%, 71/83) phase was higher in males. In addition, the highest average values of AST (60.1±58.9) and ALT (35.0±36.6), were also seen in male donors. Despite that, the female gender presents 1.61 times (95% CI: 0.33 - 7.80, p=0.557), more likely to develop chronic liver disease. Even so, no significant difference in men’s or women’s AST and ALT means was observed (p>0.05). Suspicion of liver disease in the acute (66.7%, 14/21) or chronic (54.2%, 45/83) phase was higher in donors residing in urbanized areas. However, the highest mean values of AST (67.3 ± 77.0), ALT (37.0±49.1), as well as more chances [OR: 1.69 (95% CI: 0.62 – 4.61), p=0.557] to develop chronic liver disease were observed in donors from non-urbanized areas. Suspected acute (90.5%, 19/21) or chronic (94.0%, 78/83) liver injury was more observed in donors with a low educational level, as well as 1.64 times (95% CI: 0.30 – 9.12, p=0.571) more likely to progress to chronic liver disease, although higher AST (111±162) and ALT (38.5±15.8) values, observed in donors with a high educational level. A statistically significant difference was observed between educational level and AST values, with the AST values of donors with high education twice as high compared to donors with low education (p=0.013). The employed donors were those who most had suspected acute (71.4%, 15/21) or chronic liver (81.9%, 68/83) disease and also to be the ones with the highest AST (61.8±60.6) and ALT (34.4±37.5) values. Despite that, unemployed donors were 1.81 times (95% CI: 0.60 – 5.45, p=0.289) more likely to develop chronic liver disease than employed donors. Married and unmarried donors had the same chances of developing chronic liver disease, despite unmarried donors predominating with suspected acute (95.2%, 20/21) or chronic (95.2%, 79/83) liver injury, as well as presenting the highest values of AST (60.0±57.7) and ALT (34.4±35.4).