Clinical and histological features of patients with chronic hepatitis B virus infection in the grey zone

被引：12

作者：

Gan, Qin Yi ^{[1
,2
]}

Wang, Jie Xiao ^{[1
]}

Qian, Feng ^{[3
]}

Wang, Yin Ling ^{[3
]}

Huang, Yan ^{[1
]}

Zhang, Zheng Lan ^{[1
,4
]}

Jiang, Shao Wen ^{[1
]}

Zhang, Chen Xi ^{[1
]}

Cai, Ming Hao ^{[1
]}

Qian, Cong ^{[1
]}

Fu, Hao Shuang ^{[1
]}

Zhao, Shuang ^{[1
]}

Zhou, Hui Juan ^{[1
,5
]}

Cao, Zhu Jun ^{[1
,5
]}

Xie, Qing ^{[1
,5
]}

机构：

[1] Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Infect Dis, Sch Med, Shanghai, Peoples R China

[2] Zhejiang Univ, Affiliated Hosp 1, Dept Gastroenterol, Sch Med, Hangzhou, Peoples R China

[3] Soochow Univ, Dept Infect Dis, Affiliated Infect Dis Hosp, Suzhou, Peoples R China

[4] Fudan Univ, Shanghai Pudong Hosp, Dept Infect Dis, Pudong Med Ctr, Shanghai, Peoples R China

[5] Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Infect Dis, Sch Med, 197 Ruijin 2nd Rd, Shanghai, 20025, Peoples R China

来源：

JOURNAL OF VIRAL HEPATITIS | 2023年 / 30卷 / 10期

基金：

中国国家自然科学基金;

关键词：

alanine aminotransferase; chronic hepatitis B; grey zone; immune status; liver histology; SIMPLE NONINVASIVE INDEX; SIGNIFICANT FIBROSIS; CIRRHOSIS; PREDICT; DISEASE;

D O I：

10.1111/jvh.13873

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Chronic HBV infection patients who do not conform to any of the usual immune states are regarded as 'grey zone' patients. We aimed to investigate the proportion of chronic HBV infection patients in the grey zone, and evaluate the clinical characteristics and liver pathological changes in grey zone patients. Clinical data of 1391 treatment-naive chronic HBV infection patients with liver biopsy were collected. Natural history of HBV infection was determined based on European Association for the Study of the Liver (EASL) 2017, American Association for the Study of Liver Diseases (AASLD) 2018 and Chinese 2019 guidelines for the prevention and treatment of chronic HBV infection. Significant liver histological changes and associated risk factors of normal ALT grey zone patients were analysed. According to EASL, AASLD and Chinese criteria, there were 50.0%, 28% and 37.4% chronic HBV infection patients in the grey zone. Among the 353 grey zone patients with normal ALT, 72.4% had significant liver histological changes. ALT (optimal cut-off value 25 IU/L) and HBV DNA (optimal cut-off value 18,000 IU/mL) were independent risk factors of significant liver histological abnormalities. In conclusion, a substantial proportion of grey zone patients with normal ALT have significant liver histological changes that can be predicted by levels of serum ALT and HBV DNA. These results provide guidance of antiviral treatment in grey zone patients.

引用

页码：803 / 809

页数：7

共 21 条

[21] Prognostic determinants for chronic hepatitis B in Asians: therapeutic implications [J].

Yuen, MF ;

Yuan, HJ ;

Wong, DKH ;

Yuen, JCH ;

Wong, WM ;

Chan, AOO ;

Wong, BCY ;

Lai, KC ;

Lai, CL .

GUT, 2005, 54 (11) :1610-1614

← 1 2 3 →