ArticleClinical and molecular hepatology2023
Long-term prognosis and the need for histologic assessment of chronic hepatitis B in the serological immune-tolerant phase.
Article in Clinical and molecular hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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19 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Vibration-controlled transient elastography for significant fibrosis in treatment-naïve chronic hepatitis B patients: A systematic review and meta-analysis.Clinical and molecular hepatology · 2024Pooled it
- KASL clinical practice guidelines for management of chronic hepatitis B Endorsed by the East Asia Liver Alliance (EALA).Clinical and molecular hepatology · 2026Article
- Heterogeneity Analysis of HBeAg-Positive Chronic Hepatitis B Patients with Ultra-High Viral Load (HBV DNA ≥ 7.0 logJournal of clinical medicine · 2026Article
- Longitudinal observation of chronic domestic cat hepadnavirus infection in cats with evidence of extrahepatic involvement.Journal of feline medicine and surgery · 2025Article
- Unraveling Demographic Patterns in Hepatitis B Clinical and Laboratory Profiles: Insights From a Ghanaian Cohort: A Retrospective Study.Health science reports · 2025Article
- HBeAg-positive CHB patients with indeterminate phase associated with a high risk of significant fibrosis.Virology journal · 2024Article
- Significant liver histological change is common in HBeAg-positive chronic hepatitis B with normal ALT.BMC infectious diseases · 2024Article
- Lack of association between early on-treatment HBeAg seroclearance and development of hepatocellular carcinoma or decompensated cirrhosis.JHEP reports : innovation in hepatology · 2024Article
- Lower HBV DNA level is associated with more severe liver fibrosis in HBeAg-positive chronic hepatitis B with normal alanine transaminase.Virology journal · 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
- [Rethinking the natural history staging for chronic hepatitis B virus infection].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Article
- HBeAg-positive grey-zone patients: Treatment beyond guideline recommendations?Clinical and molecular hepatology · 2023Article
- Core indicators related to the elimination of hepatitis B and C virus infection in South Korea: A nationwide study.Clinical and molecular hepatology · 2023Article
- The imitator of immune-tolerant chronic hepatitis B: A killer in disguise.Clinical and molecular hepatology · 2023Article
- Letter regarding "Long-term prognosis and the need for histologic assessment of chronic hepatitis B in the serological immune-tolerant phase".Clinical and molecular hepatology · 2023Article
- Correspondence on Letter regarding "Long-term prognosis and the need for histologic assessment of chronic hepatitis B in the serological immune tolerant phase".Clinical and molecular hepatology · 2023Article
- Is liver biopsy essential to identifying the immune tolerant phase of chronic hepatitis B?Clinical and molecular hepatology · 2023Article
- [Early antiviral treatment response in HBeAg-positive chronic HBV infected-patients with high viral load and normal ALT].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
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9 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND/
aimsThe histologic status of the immune-tolerant (IT) phase of chronic hepatitis B relative to long-term outcomes is unclear. This study aimed to discover how the serological criteria currently in use correspond to histologic criteria in determining the IT phase and indication for liver biopsy.
methodsPatients in the serological IT phase determined by positive hepatitis B e antigen, hepatitis B virus (HBV) DNA ≥106 IU/mL, and normal or minimally elevated alanine aminotransferase (ALT) ≤60 IU/L, who underwent liver biopsy at three different hospitals were included. The distribution of the histologic IT phase, defined as fibrosis of stage 1 or less and inflammation of grade 1 or less, was compared with that of the serological IT phase. The risk factors for the incidence of liver-related events, such as hepatocellular carcinoma, liver cirrhosis, liver transplantation, and death, were also analyzed.
resultsEighty-two (31.7%) out of 259 clinically suspected IT phase patients belonged to the histologic IT phase. Age over 35, high AST, and low albumin were useful for ruling out the histologic IT phase. Risk factors predicting liver-related events were age and significant fibrosis stage. There was no significant difference in the proportion of histologic IT phase and clinical prognosis between normal ALT and mildly elevated ALT groups. However, even in patients with normal ALT, age was an important factor in predicting the presence of the histologic IT phase.
conclusionA significant number of patients who belonged to the serological IT phase were not in the histologic IT phase. Patients over 35 years and those with high AST, low albumin, and low HBV DNA levels were more likely to experience poor long-term clinical outcomes. Therefore, additional histologic assessment should be considered.
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