Journal of Clinical Hepatology
This study retrospectively analyzed 271 cases of chronic HBV infection during the uncertain period, using liver biopsy to determine their histopathological characteristics of the liver tissue, and found that 22.5% had significant inflammation (≥G2), and 45.8% had significant fibrosis (≥S2). The multi-factor logistic regression model confirmed that ALT≥30/19 U/L (male/female), HBV DNA≥2000 IU/mL, and LSM≥6.0 kPa were independent risk factors for significant inflammation; while HBV DNA≥2000 IU/mL and LSM≥6.0 kPa were independent predictors of significant liver fibrosis. The advantage of this study lies in the fact that all cases were diagnosed by liver biopsy, and the staging was strictly based on the latest guidelines, focusing on the clinical controversy - the timing of treatment for patients in the uncertain period. Innovatively integrating ALT, viral load, and LSM as non-invasive indicators, a risk identification model for clinical decision-making was constructed, providing evidence-based support for individualized antiviral treatment.
This study reveals a high proportion of occult liver tissue damage in patients with chronic HBV infection during the uncertain period, indicating that this group is not "low risk," and some patients urgently need to start antiviral treatment to prevent the progression of liver disease. The research results support using ALT thresholds, HBV DNA levels, and LSM as key screening tools, which helps identify high-risk populations without relying on liver biopsy, improving the efficiency and accessibility of diagnosis and treatment. This not only provides high-quality evidence for optimizing the management strategies for patients in the uncertain period in existing guidelines but also contributes Chinese data to achieving the WHO's goal of eliminating the public health threat of viral hepatitis by 2030. Future multi-center prospective studies will further verify and promote this achievement.
Objective: To investigate the features of liver histopathological damage in patients with indeterminate phase of chronic HBV infection…
