Liver histological changes in untreated chronic hepatitis B patients in indeterminate phase  

作　　者：De-Liang Huang Qin-Xian Cai Guang-De Zhou Hong Yu Zhi-Bin Zhu Jing-Han Peng Jun Chen 

机构地区：[1]Department of Liver Diseases,The Third People’s Hospital of Shenzhen,Shenzhen 510000,Guangdong Province,China [2]Department of Pathology,Beijing Youan Hospital,Capital Medical University,Beijing 100000,China [3]Department of Pathology,National Clinical Research Centre for Infectious Disease,The Third People's Hospital of Shenzhen and the Second Hospital Affiliated with the Southern University of Science and Technology,Shenzhen 518112,Guangdong Province,China

出　　处：《World Journal of Hepatology》2024年第6期920-931,共12页世界肝病学杂志（英文版）（电子版）

基　　金：Supported by Construction of Key Medical Disciplines in Shenzhen,No.SZXK076.

摘　　要：BACKGROUND Studies with large size samples on the liver histological changes of indeterminate phase chronic hepatitis B(CHB)patients were not previously conducted.AIM To assess the liver histological changes in the indeterminate phase CHB patients using liver biopsy.METHODS The clinical and laboratory data of 1532 untreated CHB patients were collected,and all patients had least once liver biopsy from January 2015 to December 2021.The significant differences among different phases of CHB infection were compared with t-test,and the risk factors of significant liver histological changes were analyzed by the multivariate logistic regression analysis.RESULTS Among 1532 untreated CHB patients,814(53.13%)patients were in the indeterminate phase.Significant liver histological changes(defined as biopsy score≥G2 and/or≥S2)were found in 488/814(59.95%)CHB patients in the indete-rminate phase.Significant liver histological changes were significant differences among different age,platelets(PLTs),and alanine aminotransferase(ALT)subgroup in indeterminate patient.Multivariate logistic regression analysis indicated that age≥40 years old[adjust odd risk(aOR),1.44;95%confidence interval(CI):1.06-1.97;P=0.02],PLTs≤150×10^(9)/L(aOR,2.99;95%CI:1.85-4.83;P<0.0001),and ALT≥upper limits of normal(aOR,1.48;95%CI:1.08,2.05,P=0.0163)were independent risk factors for significant liver histological changes in CHB patients in the indeterminate phase.CONCLUSION Our results suggested that significant liver histological changes were not rare among the untreated CHB patients in indeterminate phase,and additional strategies are urgently required for the management of these patients.

关 键 词：Chronic hepatitis B Indeterminate phase Gray-zone Liver biopsy Pathological histology Risk factors 

分 类 号：R512.62[医药卫生—内科学] R575.5[医药卫生—临床医学]