{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:36:26Z","timestamp":1790753786437,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Immunity Inflam &amp;amp; Disease"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study aimed to investigate the role of immunocompetence in chronic hepatitis B (CHB) patients with normal alanine transaminase (ALT) levels and negative hepatitis B e antigen (HBeAg) in the risk assessments of the progression of liver fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected the clinical data of 57 patients with CHB, with normal ALT levels and negative HBeAg from December 2020 to December 2022. With hepatitis B virus (HBV) DNA\u2009&gt;\u200920\u2009IU\/mL and ALT\u2009\u2264\u200940\u2009U\/L, these patients had never undergone antiviral therapy. The levels of CD4<jats:sup>+<\/jats:sup>, CD4<jats:sup>+<\/jats:sup>CD25<jats:sup>+<\/jats:sup>, CD8<jats:sup>+<\/jats:sup>, and CD4<jats:sup>+<\/jats:sup>CD25<jats:sup>+<\/jats:sup>CD127<jats:sup>LOW<\/jats:sup> regulatory T cells (Tregs) in the patients were detected using flow cytometry; the liver stiffness measurement (LSM) values of the patients were detected using Fibroscan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a statistically significant difference between the levels of fibrosis\u20104 (FIB\u20104) and hepatitis B surface antigen (HBsAg) when the cutoff point was HBsAg\u2009\u2265\u20091500 (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). FIB\u20104 was negatively correlated with HBsAg (<jats:italic>R<\/jats:italic>\u2009=\u2009\u22120.291, <jats:italic>p<\/jats:italic>\u2009=\u2009.028) and positively correlated with age (<jats:italic>R<\/jats:italic>\u2009=\u20090.787, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). LSM was negatively correlated with Treg but this correlation was not statistically significant (<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05). Findings based on the analysis using logistic regression were as follows: (i) age was the independent risk factor when FIB\u20104 was used as the indicator for assessing liver fibrosis; (ii) Treg was the independent risk factor when LSM was used as the indicator for assessing liver fibrosis. When Treg was used to predict liver fibrosis, the cutoff value, diagnostic efficacy, area under the receiver operating characteristic (ROC) curve, and <jats:italic>p<\/jats:italic> value of the ROC curve were 6.875, 0.641, 0.84, and .027, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Age and Treg are independent risk factors for progressive liver fibrosis. The cutoff value of Treg\u2009&gt;\u20096.81 indicates the need for timely antiviral treatment and can serve as an indicator for evaluating liver fibrosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/iid3.1134","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T13:53:20Z","timestamp":1705499600000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["High immunocompetence in chronic hepatitis patients with normal alanine transaminase levels and and negative hepatitis B e\u2010antigen for the progression of liver fibrosis"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5332-3862","authenticated-orcid":false,"given":"Bianqiao","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Fuzhou Second Hospital Fujian China"},{"name":"Department of Clinical Medicine Fujian Medical University Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Fujian Medical University Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Fujian Medical University Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiming","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Fujian Medical University Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xunyuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Fujian Medical University Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Fujian Medical University Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meimei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Infection Management Fuzhou Second Hospital Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miaomiao","family":"Huo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Fuzhou Second Hospital Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2021.822813"},{"issue":"12","key":"e_1_2_10_3_1","first-page":"2648","article-title":"Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)","volume":"35","author":"Chinese Society of Infectious Diseases, Chinese Medical Association, Chinese Society of Hepatology, Chinese Medical Association","year":"2019","journal-title":"J Clin Hepatol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00050-4"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29800"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.03.021"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-015-9675-4"},{"issue":"5","key":"e_1_2_10_8_1","first-page":"582","article-title":"Natural history and long\u2010term outcome of chronic hepatitis B virus infection","volume":"31","author":"Wang H","year":"2010","journal-title":"J Capit Med Univ"},{"key":"e_1_2_10_9_1","first-page":"49","article-title":"Inactive hepatitis B carriers: outcomes of patients followed at H\u00f4pital Principal de Dakar, Senegal","volume":"31","author":"Diallo I","year":"2018","journal-title":"Pan Afr Med J"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.10.027"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinre.2018.10.017"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14182"},{"issue":"12","key":"e_1_2_10_13_1","first-page":"2568","article-title":"Clinical features of immune escape phase and immune control phase of chronic HBV infection","volume":"34","author":"Bai XX","year":"2018","journal-title":"J Clin Hepatol"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcb.27959"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-022-02471-y"},{"issue":"2","key":"e_1_2_10_16_1","first-page":"131","article-title":"Expert opinion on expanding anti\u2010HBV treatment for chronic hepatitis B","volume":"30","author":"Chinese Society of Hepatology, Chinese Medical Association","year":"2022","journal-title":"Chin J Hepatol"},{"issue":"7","key":"e_1_2_10_17_1","first-page":"1477","article-title":"HBeAg\u2010negative chronic HBV\u2010infected individuals with normal alanine aminotransferase and an age of \u226430 years should be taken seriously when expanding anti\u2010HBV treatment for chronic hepatitis B","volume":"38","author":"Liu Y","year":"2022","journal-title":"J Clin Hepatol"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22476"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13185"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-021-10153-2"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16067"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26385"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.065136"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15311"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2021.103389"},{"key":"e_1_2_10_26_1","doi-asserted-by":"crossref","unstructured":"LiTY YangY ZhouG TuZK. Immune suppression in chronic hepatitis B infection associated liver disease: A review.World J Gastroenterol.2019;25(27):3527\u20103537.","DOI":"10.3748\/wjg.v25.i27.3527"},{"issue":"16","key":"e_1_2_10_27_1","first-page":"2415","article-title":"Analysis of the effect of Treg cells on long\u2010term immune tolerance status in patients with different stages of chronic HBV infection","volume":"28","author":"Zhou GL","year":"2018","journal-title":"Chin J Nosocomiol"},{"issue":"3","key":"e_1_2_10_28_1","first-page":"196","article-title":"The role of Treg cells in the immune tolerance mechanism of chronic HBV infection","volume":"29","author":"Liu M","year":"2015","journal-title":"Chin J Exp Clin Virol"},{"issue":"8","key":"e_1_2_10_29_1","first-page":"540","article-title":"Interpretation of chronic hepatitis B prevention and treatment guidelines","volume":"37","author":"Lu HY","year":"2020","journal-title":"J Clin Inter Med"},{"issue":"1","key":"e_1_2_10_30_1","first-page":"1","article-title":"Guidelines for the prevention and treatment of chronic hepatitis B (version 2022)","volume":"36","author":"Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Infectious Diseases, Chinese Medical Association","year":"2023","journal-title":"Infect Dis Info"},{"issue":"6","key":"e_1_2_10_31_1","first-page":"793","article-title":"Consensus on the diagnosis and therapy of hepatic fibrosis (2019)","volume":"22","author":"Lu LG","year":"2019","journal-title":"J Pract Hepatol"},{"issue":"9","key":"e_1_2_10_32_1","first-page":"2033","article-title":"Should chronic hepatitis B in the indeterminate phase be treated?","volume":"37","author":"Zhuang H","year":"2021","journal-title":"J Clin Hepatol"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.2064"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2021.103389"},{"key":"e_1_2_10_35_1","first-page":"11","volume-title":"The timing of antiviral therapy in chronic HBV patients with normal ALT and positive HBVDNA","author":"Liu ZH","year":"2015"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23348"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/eji.201970107"}],"container-title":["Immunity, Inflammation and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/iid3.1134","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T07:48:49Z","timestamp":1751010529000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/iid3.1134"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/iid3.1134"],"URL":"https:\/\/doi.org\/10.1002\/iid3.1134","archive":["Portico"],"relation":{},"ISSN":["2050-4527","2050-4527"],"issn-type":[{"value":"2050-4527","type":"print"},{"value":"2050-4527","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-06-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e1134"}}