ArticlePloS one2018
Clinical and histopathological features of chronic hepatitis B virus infected patients with high HBV-DNA viral load and normal alanine aminotransferase level: A multicentre-based study in China.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Histologic changes in immune-tolerant patients with chronic hepatitis B: a systematic review and meta-analysis.Scientific reports · 2023Pooled it
- Efficacy of a Chinese herbal formula on hepatitis B e antigen-positive chronic hepatitis B patients.World journal of gastroenterology · 2020Trial
- Noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis B in the immune-tolerant phase.Scientific reports · 2025Article
- Prevalence and Serological Predictors of Liver Fibrosis in Vietnamese Chronic Hepatitis B Patients with Persistently Normal or Mildly Elevated Aminotransferase Level.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2025Article
- [Long-term therapeutic outcomes of antiviral treatment in patients with chronic hepatitis B infection with normal alanine aminotransferase, mild liver inflammation, and fibrosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Article
- HBeAg-positive CHB patients with indeterminate phase associated with a high risk of significant fibrosis.Virology journal · 2024Article
- Risk factors for significant histological changes in both HBeAg positive and negative treatment-naive chronic hepatitis B with persistently normal alanine aminotransferase level.BMC infectious diseases · 2024Article
- [HBeAg-positive patients hepatic tissue inflammatory activity and influencing factors during normal ALT and indeterminate phases].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Article
- Metabolic Syndrome, Nonalcoholic Fatty Liver Disease, and Chronic Hepatitis B: A Narrative Review.Infectious diseases and therapy · 2023Review
- Quantitative HBsAg versus HBV DNA in Predicting Significant Hepatitis Activity of HBeAg-Positive Chronic HBV Infection.Journal of clinical medicine · 2021Article
- [Should the threshold of alanine aminotransferase for initiating antiviral treatment of chronic hepatitis B be revised?]Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2021Article
- Significant Histologic Changes Are Not Rare in Treatment-naive Hepatitis B Patients with Normal Alanine Aminotransferase Level: A Meta-analysis.Journal of clinical and translational hepatology · 2021Article
- Analysis of pathological changes and related factors in liver tissue of HBeAg-negative patients with low HBsAg levels.Clinical and experimental medicine · 2020Article
- Association of hepatitis B genotypes with clinical profile of patients with chronic hepatitis B.International journal of molecular epidemiology and genetics · 2020Article
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Authors and funding
12 authors.
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Abstract
backgroundThe aim of this study is to reveal the clinical and histopathological features of HBsAg-positive and HBeAg-positive chronic hepatitis B infected patients with high level of HBV DNA, from 17 hospitals and medical centres in China, with alanine aminotransferase levels within the lower region of normal range versus those with levels within the upper region of normal range and to investigate the clinical risk factors for the requirement of treatment through the examination of liver biopsy.
methodsLiver biopsy was performed on high level of HBV DNA of 455 patients with HBsAg-positive and HBeAg-positive chronic hepatitis B infection and persistently normal alanine aminotransferase level. Liver necroinflammation and fibrosis were graded per the Knodell histological activity index and Ishak's fibrosis score, respectively. Univariate analysis of the clinical parameters versus necroinflammation and fibrosis was carried out.
resultsOf the subjects in this multicentre-based study, 5.49% and 10.11% had significant necroinflammation with Knodell histological activity index ≥ 9 and hepatic fibrosis stages with Ishak scores ≥ 3, respectively. The subjects were stratified into three age groups (30-39, 40-49 and ≥ 50 years), and our data clearly suggested that age, particularly in the age group over 50, was an independent predictor of liver necroinflammation and fibrosis. Lower HBV-DNA viral levels were found in patients with Knodell histological activity index ≥ 9 or advanced fibrosis (Ishak scores ≥ 3).
conclusionOur results showed that histological changes in liver tissues were observed in a significant proportion of patients with persistently normal alanine aminotransferase level. According to the data evaluation results, liver biopsy is advisable for HBeAg-positive chronic hepatitis B infected patients aged older than 40 and high HBV-DNA viral load in China.
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