{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T19:16:17Z","timestamp":1761765377466},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2011,3,1]],"date-time":"2011-03-01T00:00:00Z","timestamp":1298937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:p><jats:bold>Summary.\u2002<\/jats:bold> Current guidelines recommend antiviral therapy in chronic hepatitis B (HBV) patients with significant histological disease. We aimed to compare histological fibrosis (METAVIR, \u2265F2) in patients with HBV DNA \u226520\u2003000\u2003IU\/mL <jats:italic>vs<\/jats:italic>\u22652000\u2003IU\/mL and identify predictors of fibrosis. We performed prospective liver biopsies on 203 HBeAg\u2010negative patients in four groups: Group I (<jats:italic>n<\/jats:italic>\u2003=\u200355): HBV DNA \u226520\u2003000\u2003IU\/mL and persistently elevated alanine aminotransferase (ALT) levels (PEALT; &gt;40\u2003U\/L); Group II (<jats:italic>n<\/jats:italic>\u2003= 34): HBV DNA \u226520\u2003000\u2003IU\/mL and persistently normal ALT (PNALT); Group III (<jats:italic>n<\/jats:italic>\u2003=\u200340): HBV DNA &lt;20\u2003000\u2003IU\/mL and PEALT; and Group IV (<jats:italic>n<\/jats:italic>\u2003=\u200374): HBV DNA &lt;20\u2003000\u2003IU\/mL, and PNALT. We reanalysed all groups in relation to updated cut\u2010off for treatable viremia (2000\u2003IU\/mL). Genotype D was detected in 86% of patients. Hepatic fibrosis \u2265F2 was detected in 72.7%, 52.9%, 57.5% and 18.9% in Groups I\u2013IV, respectively (<jats:italic>P\u2003<\/jats:italic>&lt;<jats:italic>\u2003<\/jats:italic>0.0001). Except in Group II with a trend for lower \u2265F2 fibrosis (<jats:italic>P\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>0.067), there was no significant difference by using HBV DNA cut\u2010off 20\u2003000 <jats:italic>vs<\/jats:italic> 2000\u2003IU\/mL. Multivariate logistic regression analysis identified study Group IV (OR, 0.0276; CI: 0.088\u20130.868; <jats:italic>P\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>0.0276) and milder (A0\u20131) necroinflammatory grade (OR, 0.135; CI: 0.063\u20130.287; <jats:italic>P\u2003<\/jats:italic>&lt;<jats:italic>\u2003<\/jats:italic>0.0001) as independent predictors of \u2265F2 fibrosis. The specificity, positive and negative predictive values for PEALT in detection of \u2265F2 fibrosis for viremia \u22652000\u2003IU\/mL (80%, 69% and 65%, respectively) or \u226520\u2003000\u2003IU\/mL (86%, 73% and 63%, respectively) were similar, with a marginal gain in sensitivity (51%<jats:italic>vs<\/jats:italic> 42%, respectively). Significant fibrosis is prevalent in a large proportion of HBeAg\u2010negative patients with high viremia and persistently normal ALT. Lower HBV DNA cut\u2010offs could be adopted with marginal gains in fibrosis detection and without loss of diagnostic accuracy.<\/jats:p>","DOI":"10.1111\/j.1365-2893.2011.01437.x","type":"journal-article","created":{"date-parts":[[2011,3,1]],"date-time":"2011-03-01T22:19:28Z","timestamp":1299017968000},"source":"Crossref","is-referenced-by-count":25,"title":["Discriminant value of serum HBV DNA levels as predictors of liver fibrosis in chronic hepatitis B"],"prefix":"10.1111","volume":"18","author":[{"given":"F. M.","family":"Sanai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Helmy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. 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Q.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. S.","family":"Alghamdi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Farah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Al\u2010Hamoudi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Saadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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