{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:13:08Z","timestamp":1792696388092,"version":"4.5.0"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>Liver biopsies are recommended to exclude significant liver inflammation in patients with chronic hepatitis B (CHB) with elevated HBV DNA but without other indications for antiviral treatment. We aimed to investigate the proportions and determinants of significant inflammation in Asian patients with CHB with detectable HBV DNA. We conducted a cross\u2010sectional study that retrospectively included 581 patients with CHB with detectable HBV DNA who had undergone liver biopsy. Liver inflammation and fibrosis were staged by Scheuer\u2019s classification. Significant inflammation and significant fibrosis were defined as G\u00a0\u2265\u00a02 and S\u00a0\u2265\u00a02, respectively. There were 179 (30.8%) patients with alanine aminotransferase (ALT)\u00a0&lt;\u00a01\u00a0\u00d7\u00a0upper limit of normal (ULN), 205 (35.3%) patients with ALT 1\u20102\u00a0\u00d7\u00a0ULN, and 197 (33.9%) patients with ALT\u00a0&gt;\u00a02\u00a0\u00d7\u00a0ULN. A total of 397 (68.3%) patients had significant inflammation, and 340 (58.5%) patients had significant fibrosis. Significant inflammation was found in 85% of patients with significant fibrosis and in 44.8% of patients without significant fibrosis. Furthermore, 28.7% of patients with CHB with detectable HBV DNA and normal ALT in the absence of significant fibrosis had significant inflammation. Moderate HBV DNA (5\u20107 log<jats:sub>10<\/jats:sub> IU\/mL) was a risk factor for significant inflammation (odds ratio [OR] 6.929, 95% confidence interval [CI] 2.830\u201016.966, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.001) in patients with CHB with detectable HBV DNA, especially for patients with detectable HBV DNA and normal ALT in the absence of significant fibrosis (adjusted OR 13.161, 95% CI 1.026\u2010168.889, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.048). <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> A high proportion of CHB patients with detectable HBV DNA and normal ALT in the absence of significant fibrosis have significant liver inflammation. Liver biopsies are recommended to evaluate liver inflammation in such patients, especially for those with moderate HBV DNA.<\/jats:p>","DOI":"10.1002\/hep4.1859","type":"journal-article","created":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T07:07:27Z","timestamp":1637046447000},"page":"855-866","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":69,"title":["Presence of Liver Inflammation in Asian Patients With Chronic Hepatitis B With Normal ALT and Detectable HBV DNA in Absence of Liver Fibrosis"],"prefix":"10.1097","volume":"6","author":[{"given":"Jiacheng","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases,Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China"},{"name":"Institute of Viruses and Infectious Diseases,Nanjing University,Nanjing,Jiangsu,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China"},{"name":"Institute of Viruses and Infectious Diseases,Nanjing University,Nanjing,Jiangsu,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruifei","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Nanjing Drum Tower Hospital Clinical 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Medicine,Nanjing,Jiangsu,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minxin","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China"},{"name":"Institute of Viruses and Infectious Diseases,Nanjing University,Nanjing,Jiangsu,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengxia","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China"},{"name":"Institute of Viruses and Infectious Diseases,Nanjing University,Nanjing,Jiangsu,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China"},{"name":"Institute of Viruses and Infectious Diseases,Nanjing University,Nanjing,Jiangsu,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Viruses and Infectious Diseases,Nanjing 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