ArticleHepatology communications2024
Histological features of chronic hepatitis B patients with normal alanine aminotransferase according to different criteria.
Article in Hepatology communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 11 citations in OpenAlex.
- 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
- Normal ALT masks occult liver injury in young chronic hepatitis B patients: a call for early treatment intervention.Frontiers in cellular and infection microbiology · 2026Article
- Time for a globally unified chronic HBV terminology?JHEP reports : innovation in hepatology · 2025Review
- YKL-40 in Virus-Associated Liver Disease: A Translational Biomarker Linking Fibrosis, Hepatocarcinogenesis, and Liver Transplantation.International journal of molecular sciences · 2025Review
- Correspondence to letter to the editor on "Non-linear association between liver fibrosis scores and viral load in patients with chronic hepatitis B".Clinical and molecular hepatology · 2025Article
- The potential value of fatty acid binding protein 1 in Chronic HBV-related liver disease progression assessment.BMC infectious diseases · 2024Article
- Non-linear association between liver fibrosis scores and viral load in patients with chronic hepatitis B.Clinical and molecular hepatology · 2024Article
- [Comparison of the population covered by the 2024 version of the WHO's hepatitis B prevention and treatment guidelines and the Chinese antiviral treatment guidelines].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Article
- [A new concept from a global perspective for expanding the treatment of chronic hepatitis B].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Article
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Authors and funding
26 authors at 4 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe upper limits of normal (ULNs) for alanine aminotransferase (ALT) are different among international guidelines for chronic hepatitis B (CHB). We aimed to investigate the proportion of significant histological disease in Asian patients with CHB with detectable hepatitis B virus (HBV) DNA under diverse ALT ULNs.
methodsConsecutive patients with CHB and detectable HBV DNA who underwent liver biopsy were retrospectively included from four tertiary hospitals. Above grade 2 inflammation and stage 2 fibrosis were defined as significant inflammation and significant fibrosis, respectively. Significant histological disease was defined as above grade 2 inflammation or stage 2 fibrosis.
resultsAmong the 414 patients with detectable HBV DNA and normal ALT, the proportion of those with significant histological disease was lower (59.7%) according to the ULN for ALT at 30/19 U/L (male/female), while the corresponding proportions were 66.7% and 62.3% according to the ULNs of 40 U/L and 35/25 U/L (male/female), respectively. In patients with detectable HBV DNA and normal ALT levels without significant fibrosis, the proportions of significant inflammation were comparable among different ULNs of ALT at 40 U/L (30.7%), 35/25 U/L (27.3%) and 30/19 U/L (25.0%). The proportion of significant histological disease was significantly lower in patients with normal ALT for 2 determinations at least 6 months apart compared to patients with normal ALT once.
conclusionsAlthough a more stringent ALT ULN may reduce the risk of the presence of significant histological disease in patients with detectable HBV DNA, the rates of significant histological disease remain high. Persistently normal ALT levels are more important for excluding patients with CHB with a high probability of significant histological disease.
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