The degree and influencing factors of liver fibrosis in patients with chronic hepatitis B in the grey zone with hbeAg-positive and normal ALT
Objective:To analyze the degree of liver fibrosis in hepatitis Be antigen(HBeAg)-positive patients with uncertain normal alanine aminotransferase(ALT),and to provide a basis for the judgment of the condition of HBeAg positive patients with uncertain normal ALT.Methods:From January 2017 to December 2021,the patients with HBeAg positive normal ALT HBV DNA level of lower than 2×107 IU/ml and higher than 20 IU/ml were taken as the research objects.Liver histopathological examination was performed,and the patients'age,gender,HBV infection time,liver function,HBsAg level,HBV DNA load,genotype,portal vein diameter,splenic vein diameter,spleen thickness were collected.Logistic regression was used to analyze the influencing factors of significant fibrosis,and receiver operator characteristic(ROC)curve was used to evaluate its efficacy.Results:Among 178 cases,there were 6 cases of S0(3.4%),67 cases of S1(37.6%),84 cases of S2(46.6%),14 cases of S3(7.9%)and 8 cases of S4(4.5%).105(59.0%)with fibrosis degree≥S2.Logistic regression analysis showed that significant liver fibrosis was independently correlated with infection time(OR =1.101,95%CI:1.000～1.212;P =0.049),HBV DNAlg(OR =1.280,95%CI =1.023～1.600;P =0.031),portal vein(OR =1.611～95%CI =1.100～2.360;P =0.014)and spleen thickness(OR =1.276～95%CI =1.107～1.469;P =0.001),the area under curve of ROC was 0.67,0.62,0.70 and 0.67 respectively,and 0.68 and 0.57 of aminotransferase to platelet ratio index and fibrosis 4 score.Conclusion:A substantial segment of patients who were hbeAg-positive and possess indeterminate ALT levels exhibited a fibrosis stage of≥S2,necessitating the initiation of antiviral treatment.The duration of infection,levels of HBV DNA,the diameter of the portal vein,and the thickness of the spleen might possess some clinical significance in forecasting the presence of notable liver fibrosis.
NETL
NSTL
万方数据
维普
