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

• Published in: Virology journal Vol. 21; no. 1; pp. 287 - 10
• Main Authors: Li, Yuanyuan, Zhu, Yijia, Gao, Dongmei, Pan, Yifan, Wang, Jian, Zhang, Shaoqiu, Yan, Xiaomin, Zhu, Li, Zhu, Chuanwu, Liu, Xingxiang, Zhang, Zhaoping, Li, Jie, Chen, Yuxin, Huang, Rui, Wu, Chao
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 13-11-2024; BioMed Central; BMC
• Subjects: Care and treatment; Chronic hepatitis B; Cirrhosis; Complications and side effects; Diagnosis; Fibrosis; HBV DNA; Health aspects; Hepatitis associated antigen; Hepatitis B; Immune-tolerant; Indeterminate phase; Liver; Liver cirrhosis; Liver fibrosis; Measurement; Risk factors; China
• ISSN: 1743-422X; 1743-422X
• DOI: 10.1186/s12985-024-02561-1

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. This multi-center, retrospective cohort study included 719 treatment-naïve HBeAg-positive CHB patients with normal alanine aminotransferase (ALT). Patients with HBV DNA > 10.sup.6 IU/mL were categorized into immune-tolerant phase, whereas those with HBV DNA [less than or equal to] 10.sup.6 IU/mL were classified into indeterminate phase. Significant liver fibrosis and cirrhosis were determined by APRI, FIB-4, transient elastography, or liver biopsy. 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 [greater than or equal to] 30 years. HBeAg-positive CHB patients in the indeterminate phase had more severe liver fibrosis compared to those in the immune-tolerant phase.