ArticleClinical and translational gastroenterology2019
Prognosis of Untreated Minimally Active Chronic Hepatitis B Patients in Comparison With Virological Responders by Antivirals.
Article in Clinical and translational gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 24 citations in OpenAlex.
- Factors Associated with Progressive Liver Disease in Untreated HBV Patients in Tunisia.F1000Research · 2025Article
- Cost-effectiveness analysis of oral antiviral therapy in patients with indeterminate chronic hepatitis B infection.Translational gastroenterology and hepatology · 2025Article
- Hepatocellular carcinoma among patients with chronic hepatitis B in the indeterminate phase.Journal of viral hepatitis · 2024Review
- HBV-related HCC development in mice is STAT3 dependent and indicates an oncogenic effect of HBx.JHEP reports : innovation in hepatology · 2024Article
- It Is Time for a Simplified Approach to Hepatitis B Elimination.Gastro hep advances · 2023Article
- Liver Complications in Untreated Treatment-Ineligible versus Treated Treatment-Eligible Patients with Hepatitis B.Digestive diseases (Basel, Switzerland) · 2023Review
- A new approach to prevent, diagnose, and treat hepatitis B in Africa.BMC global and public health · 2023Review
- Long-term effect of chronic hepatitis B on mortality in HIV-infected persons in a differential HBV transmission setting.BMC infectious diseases · 2022Article
- Impact of tenofovir alafenamide vs. entecavir on hepatocellular carcinoma risk in patients with chronic hepatitis B.Hepatology international · 2021Article
- Negligible risks of hepatocellular carcinoma during biomarker-defined immune-tolerant phase for patients with chronic hepatitis B.Clinical and molecular hepatology · 2021Article
- Natural History of Untreated HBeAg-Positive Chronic HBV Infection With Persistently Elevated HBV DNA but Normal Alanine Aminotransferase.Clinical and translational gastroenterology · 2020Observational
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Authors and funding
8 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSerum hepatitis B virus (HBV)-DNA > 2,000 IU/mL is associated with higher risk of disease progression. However, without hepatocellular carcinoma (HCC) or cirrhosis, nucleos(t)ide analogs (NUCs) are recommended only for patients with elevated serum HBV-DNA and alanine aminotransferase ≥2 × upper normal limit.
methodsWe evaluated prognosis of untreated minimally active (MA) hepatitis patients (defined as HBV-DNA > 2,000 IU/mL, but never fulfilling current criteria for NUCs during follow-up) (untreated MA group), compared to virological responders by NUCs (NUC-VR group). Eligible patients undergoing transient elastography were consecutively enrolled. Patients with an immune-tolerant or inactive phase and with cirrhosis or HCC at enrollment were excluded. Cumulative risks of disease progression were assessed using the Kaplan-Meier method.
resultsThe untreated MA group (n = 152) had higher HBV-DNA, alanine aminotransferase, and total bilirubin levels, and lower proportions of male and positive hepatitis B e antigen, compared to the NUC-VR group (n = 641). The untreated MA group had higher risks of HCC (adjusted hazard ratio [HR] 3.485, 95% confidence interval [CI] 1.234-9.846; P = 0.018), but similar risks of cirrhotic complications (adjusted HR 0.649, 95% CI 0.227-1.854; P = 0.420), compared to the NUC-VR group. Inverse probability of treatment weighting analysis using propensity score showed that the untreated MA group had higher risks of HCC (HR 4.464, 95% CI 2.008-9.901; P < 0.001), but similar risks of cirrhotic complications (HR 1.171, 95% CI 0.594-2.309; P = 0.649), compared to the NUC-VR group. DISCUSSION: Through appropriate adjustment of potential prognostic factors, the untreated MA group consistently showed higher risks of HCC, but similar risks of cirrhotic complications, compared to the NUC-VR group. HCC risk might be reduced through earlier NUCs for the untreated MA group.
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