ArticleVirology journal2025
Reevaluating antiviral thresholds in HBV DNA-negative inactive HBsAg carriers: a multicenter histopathological analysis.
Article in Virology journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Article
- Article
- [Reflections on the novel definition and whether or not antiviral therapy for inactive HBsAg carrier state in the "Guidelines for the Prevention and Treatment of Chronic Hepatitis B (version 2022)"].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Article
- Machine learning prediction of rapid HBsAg seroclearance at week 24 in inactive carriers treated with pegylated interferon.Hepatology international · 2025Article
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Authors and funding
13 authors.
Funding
Abstract
backgroundThe definition of inactive HBsAg carriers (IHC) varies globally, particularly regarding HBV DNA thresholds. Whether HBV DNA negativity reliably predicts histological quiescence remains uncertain.
aimsThis study evaluated liver pathology in IHC patients to reassess antiviral therapy thresholds.
methodsThis multi-center, retrospective study included 231IHCs(2018-2023) stratified by HBV DNA negativity (< 20IU/mL). Liver biopsies assessed inflammation (G ≥ 2) and fibrosis (F ≥ 2); evident hepatic injury (EHI) was defined as G ≥ 2 and/or F ≥ 2. Multivariable models evaluated predictors.
resultsAmong 231 IHC patients(median age:43 years old; 95.2% ≥30 years old), 35.9%(83/231) were HBV DNA negative. The median HBsAg and HBV DNA level were 132 IU/ml and 94 IU/ml, respectively. Notably, EHI prevalence was significantly higher in HBV DNA negative patients than positive ones(44.9% vs. 31%, P = 0.04), driven by fibrosis (F ≥ 2: 42.2% vs. 21.6%, P < 0.001), challenging the assumption that HBV DNA negativity ensures low histological risk. Male sex, HBV DNA negativity, and elevated liver stiffness measurement(LSM) independently predicted EHI (OR = 3.37, AUC = 0.747).
conclusionHBV DNA negativity does not guarantee histological quiescence in inactive HBsAg carriers aged ≥ 30 years, with 44.9% exhibiting significant liver injury. In this population, LSM > 6.4 Kpa should prompt consideration of liver biopsy and/or initiation of antiviral therapy.
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