Evidence map›Paper›PMID 40108501›Full record

ArticleBMC infectious diseases2025

Liver histological study of patients with chronic hepatitis B virus infection in the grey zone.

Weijia Lin, Rongrong Ding, Shuangshuang Sun, Wei Lu, Yanbin Wang, Xinlan Zhou, Dan Huang, Xiufen Li, Zhanqing Zhang, Liang Chen

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In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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

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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

2 citing papers in PubMed.

  1. Article
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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Weijia LinDepartment of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Rongrong DingDepartment of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Shuangshuang SunDepartment of Hepatology Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Wei LuDepartment of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Yanbin WangDepartment of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Xinlan ZhouDepartment of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Dan HuangDepartment of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Xiufen LiDepartment of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Zhanqing ZhangDepartment of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China. doctorzzq@shaphc.org.
Liang ChenDepartment of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China. chenliang@shaphc.org.

Funding

Shanghai Public Health Clinical Center research project funding KY-GW-2023-28
6 · The paper itself

Abstract

BACKGROUND AND

aimThe natural history of chronic hepatitis B virus (HBV) infection is usually divided into four phases: immune tolerant (IT), immune active (IA), immune carrier (IC), and immune reactive (IR). Many patients still cannot be classified into the four phases, called "Grey Zone (GZ)". This study aimed to analyze the liver histological features of the GZ patients to guide antiviral therapy.

methodsWe retrospectively analyzed the 1454 patients with chronic HBV infection who underwent liver biopsy. GZ patients with identical serum hepatitis Be antigen (HBeAg) and alanine aminotransferase (ALT) levels as those in the IT, IA, IC, and IR phases were categorized into the IT-GZ, IA-GZ-1, IA-GZ-2, IC-GZ, and IR-GZ groups, respectively. We analyzed and compared the histological distribution of liver in these patients. We evaluated independent influencing factors for significant liver histological changes (SLHC) in patients in the GZ subgroups.

resultsAmong the 1454 patients, 690(47.5%) patients in GZ. Among the 690 patients of the GZ, 322(46.7%) patients for whom histological examinations indicated SLHC. The proportion of SLHC within the GZ subgroups was as follows: IT-GZ (50.5%), IA-GZ-1 (75.0%), IA-GZ-2 (48.4%), IC-GZ (32.1%), and IR-GZ (59.6%). In the IT-GZ group, the proportion of patients aged ≤ 30 years with SLHC was 47.1%, and in the IC-GZ group, this proportion was 42.1%.

conclusions46.7% of GZ patients had significant liver histological changes. For HBeAg-negative patients with ALT ≤ 40U/L, HBV DNA ≥ 2000IU/mL, and an age of ≤ 30 years old, antiviral therapy was recommended; if they expressed concern, a liver biopsy was suggested.

Indexed as

Hepatitis B, ChronicLiverAdolescentAdultAgedAlanine TransaminaseBiopsyFemaleHepatitis B e AntigensHepatitis B virusHumansMaleMiddle AgedRetrospective StudiesYoung AdultAlanine TransaminaseHepatitis B e AntigensChronic HBV infectionGrey zoneLiver biopsySignificant liver histological changes

Identifiers

PMID40108501
PMCPMC11924787

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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.