Evidence map›Paper›PMID 33638770›Full record

ReviewHepatology international2021

Chronic hepatitis B: the demise of the 'inactive carrier' phase.

Apostolos Koffas, Manoj Kumar, Upkar S Gill, Ankur Jindal, Patrick T F Kennedy, S K Sarin

Abstract readReview
PubMed Publisher
In one paragraph

Review in Hepatology international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
4.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 39 citations in OpenAlex.

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  16. Phenotypes of peripheral CD4Frontiers in cellular and infection microbiology · 2023
    Article
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  19. Immune Checkpoint Molecules Expressed on CD4Frontiers in microbiology · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 3 countries.

Apostolos KoffasDepartment of Gastroenterology, General University Hospital of Larisa, Larisa, Greece.ORCID http://orcid.org/0000-0002-2637-3847
Manoj KumarDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
Upkar S GillBarts Liver Centre, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Ankur JindalDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
Patrick T F KennedyBarts Liver Centre, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. p.kennedy@qmul.ac.uk.
S K SarinDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India. sksarin@ilbs.in.
Institute of Liver and Biliary Sciences · INQueen Mary University of London · GB404 General Military Hospital · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic hepatitis B (CHB) remains a global healthcare burden. Although the recent developments in the field have led to a reduction in incidence, the morbidity and mortality including liver cirrhosis and hepatocellular carcinoma (HCC) remain a formidable challenge. Advances in understanding the immunopathogenesis of CHB have led to a recent change in clinical categorization. EASL introduced the term hepatitis B 'e' antigen (HBeAg)-negative chronic infection, to replace the historical term 'inactive carrier' disease phase, the commonest CHB phase. Although this disease phase is associated with a favorable prognosis, it is not a truly 'inactive' disease phase with no ostensible liver disease, as inferred by the previous anachronistic terminology, and the risk of spontaneous reactivation and the potential risk of disease progression and HCC development are not negligible. Likewise, the APASL also uses the term "Incidentally Detected Asymptomatic Hepatitis B surface antigen (HBsAg)-positive Subject (IDAHS)", comprising all HBsAg-positive subjects who are incidentally detected during routine tests, without any previous or present symptoms of liver disease. This entity includes HBV infection with varied stages of liver disease. Antiviral treatment is generally reserved for patients with active inflammation and/or at risk of disease progression and HCC development. HBsAg loss is considered an optimal treatment endpoint, and may also be achievable in HBeAg-negative chronic infection and IDAHS. In light of this, and the emerging novel HBV therapies, lowering the treatment threshold and a 'Treat All' approach should now be considered. In this review, we summarize the literature and guidance on HBeAg-negative chronic infection, and we make a concerted effort to present the reasons why the one-dimensional term 'inactive carrier' should be abandoned.

Indexed as

Hepatitis B, ChronicCarcinoma, HepatocellularCarrier StateHepatitis B e AntigensHepatitis B Surface AntigensHepatitis B virusHumansLiver NeoplasmsHepatitis B e AntigensHepatitis B Surface AntigensChronic hepatitis BHepatitis B ‘e’ antigen-negative chronic infection‘Inactive carrier’ disease phaseIncidentally detected asymptomatic hepatitis B ‘surface’ antigen-positive subject

Identifiers

PMID33638770
OpenAlexW3131507101

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.