ArticleBMC infectious diseases2024
Significant liver histological change is common in HBeAg-positive chronic hepatitis B with normal ALT.
Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- APASL clinical practice guidelines on the management of chronic hepatitis B infection: a 2026 update.Hepatology international · 2026Guideline
- Identifying MASLD Patients with MASH or Significant Fibrosis: The Role of Lower ALT Thresholds.Journal of clinical medicine · 2026Article
- [APASL clinical practice guidelines on the management of chronic hepatitis B infection: a 2026 update].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Article
- Predictive value of serum S100A8/A9 for liver dysfunction in pregnant women with chronic hepatitis B.Virology journal · 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
- Efficacy and safety of tenofovir alafenamide in HBeAg-positive and negative chronic hepatitis B patients aged over 30 years with normal ALT and detectable HBV DNA: a 96-week retrospective two-center study.Frontiers in medicine · 2026Article
- Research Progress on Mechanisms of Immune Tolerance Induced by Hepatitis B Surface Antigen in Chronic HBV Infection.Journal of immunology research · 2026Review
- YKL-40 in Virus-Associated Liver Disease: A Translational Biomarker Linking Fibrosis, Hepatocarcinogenesis, and Liver Transplantation.International journal of molecular sciences · 2025Review
- Projected Mitigation of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B in the Gray Zone and the Immune-Tolerant Phase in the United States.Digestive diseases and sciences · 2025Article
- Liver histological study of patients with chronic hepatitis B virus infection in the grey zone.BMC infectious diseases · 2025Article
- Virological response and predictive factors for antiviral treatment in chronic HBV-related liver disease with low ALT and high HBV DNA.Frontiers in immunology · 2025Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsNumerous HBeAg-positive chronic hepatitis B (CHB) patients with persistently normal ALT have significant liver histopathology. It is imperative to identify true "immune tolerant" patients. We aimed to evaluate the liver histopathology features of HBeAg-positive CHB patients with normal ALT and the incidence of liver cirrhosis and HCC in CHB patients during follow-up.
methods179 HBeAg-positive CHB patients with normal ALT who performed liver biopsy from 2009 to 2018 were retrospectively analyzed. Liver necroinflammation ≥ G2 and/or liver fibrosis ≥ S2 was defined as significant liver histopathological change.
results57.5% patients were in the indeterminate phase with significant liver histological changes. The proportion of the patients with evident liver necroinflammation was higher in the high-normal ALT group (21-40U/L) when compared with the low-normal ALT group (≤ 20 U/L) (51.3% vs. 30.0%, p < 0.05), and patients aged ≥ 40 years had a higher proportion of significant fibrosis than those aged < 40 years (64.5% vs. 39.9%, p < 0.05). The percentages of patients with ≥ S2 and ≥ G2/S2 in the HBV DNA < 10
conclusionsHBeAg-positive CHB patients with high-normal ALT or HBV DNA < 10
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