HBeAg-positive CHB patients with indeterminate phase associated with a high risk of significant fibrosis.

IF 4 3区医学 Q2 VIROLOGY Virology Journal Pub Date : 2024-11-13 DOI:10.1186/s12985-024-02561-1

Yuanyuan Li, Yijia Zhu, Dongmei Gao, Yifan Pan, Jian Wang, Shaoqiu Zhang, Xiaomin Yan, Li Zhu, Chuanwu Zhu, Xingxiang Liu, Zhaoping Zhang, Jie Li, Yuxin Chen, Rui Huang, Chao Wu

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Abstract

Background: The risk of liver fibrosis in HBeAg-positive chronic hepatitis B (CHB) patients with indeterminate phase is not well characterized. We aimed to compare the presence of liver fibrosis in HBeAg-positive CHB patients between indeterminate phase and immune-tolerant phase.

Methods: This multi-center, retrospective cohort study included 719 treatment-naïve HBeAg-positive CHB patients with normal alanine aminotransferase (ALT). Patients with HBV DNA > 10⁶ IU/mL were categorized into immune-tolerant phase, whereas those with HBV DNA ≤ 10⁶ IU/mL were classified into indeterminate phase. Significant liver fibrosis and cirrhosis were determined by APRI, FIB-4, transient elastography, or liver biopsy.

Results: The median age of patients was 33.0 years and 59.8% of patients were male. 81.5% and 18.5% of patients were in the immune-tolerant phase and indeterminate phase, respectively. The APRI (0.33 vs. 0.27, P < 0.001), FIB-4 (1.07 vs. 0.72, P < 0.001), and liver stiffness values (7.80 kPa vs. 5.65 kPa, P = 0.011) were higher in patients with indeterminate phase than those with immune-tolerant phase. Patients in the indeterminate phase had significantly higher proportions of significant fibrosis (27.1% vs. 11.3%, P < 0.001) and cirrhosis (14.3% vs. 3.2%, P < 0.001) compared to those in the immune-tolerant phase. In the multivariate analysis, indeterminate phase (OR 2.138, 95% CI 1.253, 3.649, P = 0.005) was associated with a higher risk of significant fibrosis, especially for patients aged ≥ 30 years.

Conclusion: HBeAg-positive CHB patients in the indeterminate phase had more severe liver fibrosis compared to those in the immune-tolerant phase.

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HBeAg 阳性的慢性乙型肝炎患者的不确定期与严重纤维化的高风险有关。

背景：HBeAg阳性慢性乙型肝炎（CHB）患者肝纤维化的风险尚不明确。我们旨在比较 HBeAg 阳性的慢性乙型肝炎患者在不确定期和免疫耐受期出现肝纤维化的情况：这项多中心、回顾性队列研究纳入了 719 例丙氨酸氨基转移酶（ALT）正常、治疗无效的 HBeAg 阳性 CHB 患者。HBV DNA > 106 IU/mL 的患者被归入免疫耐受期，而 HBV DNA ≤ 106 IU/mL 的患者被归入不确定期。明显的肝纤维化和肝硬化通过 APRI、FIB-4、瞬时弹性成像或肝活检确定：患者的中位年龄为 33.0 岁，59.8% 的患者为男性。81.5%和18.5%的患者分别处于免疫耐受期和不确定期。APRI（0.33 对 0.27，P与处于免疫耐受期的患者相比，处于不确定期的 HBeAg 阳性 CHB 患者的肝纤维化更为严重。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Virology Journal 医学-病毒学

CiteScore

7.40

自引率

2.10%

发文量

186

审稿时长

1 months

期刊介绍： Virology Journal is an open access, peer reviewed journal that considers articles on all aspects of virology, including research on the viruses of animals, plants and microbes. The journal welcomes basic research as well as pre-clinical and clinical studies of novel diagnostic tools, vaccines and anti-viral therapies. The Editorial policy of Virology Journal is to publish all research which is assessed by peer reviewers to be a coherent and sound addition to the scientific literature, and puts less emphasis on interest levels or perceived impact.