ArticleJournal of clinical and translational hepatology2021
Significant Histologic Changes Are Not Rare in Treatment-naive Hepatitis B Patients with Normal Alanine Aminotransferase Level: A Meta-analysis.
Article in Journal of clinical and translational hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 17 citations in OpenAlex.
- Impact of Alanine Transaminase Thresholds on Treatment Eligibility of Patients with Chronic Hepatitis B: A Cross-sectional Study of the China Registry of Hepatitis B.Journal of clinical and translational hepatology · 2025Article
- Interim Analysis of 48-week Tenofovir Amibufenamide Treatment in Chronic Hepatitis B Patients with Normal Alanine Aminotransferase Levels: The PROMOTE Study.Journal of clinical and translational hepatology · 2025Article
- Serum ferritin as a predictive biomarker for PEG IFNα-2b efficacy in chronic hepatitis B treatment.Frontiers in cellular and infection microbiology · 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
- The potential value of fatty acid binding protein 1 in Chronic HBV-related liver disease progression assessment.BMC infectious diseases · 2024Article
- Article
- Noninvasive Models to Assess Liver Inflammation and Fibrosis in Chronic HBV Infected Patients with Normal or Mildly Elevated Alanine Transaminase Levels: Which One Is Most Suitable?Diagnostics (Basel, Switzerland) · 2024Article
- [Imperatives to strengthen HBsAg screening and expand antiviral therapy indications on hepatitis B among the general population].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- [Discussion regarding the reduction of the alanine transaminase threshold value in patients with chronic hepatitis B virus infection undergoing antiviral therapy].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- Hepatic and portal vein Doppler ultrasounds in assessing liver inflammation and fibrosis in chronic HBV infection with a normal ALT level.Frontiers in medicine · 2023Article
- Metabolic Syndrome, Nonalcoholic Fatty Liver Disease, and Chronic Hepatitis B: A Narrative Review.Infectious diseases and therapy · 2023Review
- HBeAg-negative Patients with Chronic Hepatitis B Virus Infection and Normal Alanine Aminotransferase: Wait or Treat?Journal of clinical and translational hepatology · 2022Review
- [Normal alanine aminotransferase is an appropriate indicator for the initiation of antiviral therapy in patients with chronic hepatitis B virus infection].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2021Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsChronic hepatitis B is the main cause of liver cancer. However, the most neglected group has been treatment-naive chronic hepatitis B patients with normal alanine aminotransferase (ALT). People have tended to subjectively assume that the liver lesions of these patients are not serious and do not need antiviral treatment. However, the truth is not as optimistic as we thought. We aimed in this study to analyze the proportion of significant inflammation or fibrosis in aforementioned patients.
methodsMedline, Embase, and Cochrane Library were searched up to January 10
resultsNineteen eligible studies, with 2,771 participants, were included. The pooled proportion of significant inflammation or fibrosis was 35% [95% confidence interval (CI): 27 to 43] and 30% (95% CI: 25 to 36), respectively. The pooled proportion of cirrhosis was 3% [95% CI: 1 to 5, (12 studies; 1,755 participants)]. In subgroup analysis, old age [vs. young (<40 years-old), 44% vs. 26%,
conclusionsAbout 1/3 of the treatment-naive chronic hepatitis B patients with normal ALT show significant histological changes, and some even have cirrhosis.
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