{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T02:43:53Z","timestamp":1773369833815,"version":"3.50.1"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Evidence shows people living with CHB even with a normal ALT (40U\/L as threshold) suffer histological disease and there is still little research to evaluate the potential benefit of antiviral benefits in them.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively examined 1352 patients who underwent liver biopsy from 2017 to 2021 and then obtained their 1-year follow-up data to analyze.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ALT levels were categorized into high and low, with thresholds set at &amp;gt;29 for males and &amp;gt;15 for females through Youden\u2019s Index. The high normal ALT group showed significant histological disease at baseline (56.43% <jats:italic>vs<\/jats:italic> 43.82%, p&amp;lt; 0.001), and better HBV DNA clearance from treatment using PSM (p=0.005). Similar results were obtained using 2016 AASLD high normals (male &amp;gt;30, female &amp;gt;19). Further multivariate logistic analysis showed that high normal ALT (both criterias) was an independent predictor of treatment (OR 1.993, 95% CI 1.115-3.560, p=0.020; OR 2.000, 95% CI 1.055-3.793, p=0.034) Both of the models had higher AUC compared with current scoring system, and there was no obvious difference between the two models (AUC:0.8840 <jats:italic>vs<\/jats:italic> 0.8835)<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Male &amp;gt;30 or female &amp;gt;19 and Male &amp;gt;29 or female&amp;gt;15 are suggested to be better thresholds for normal ALT. Having a high normal ALT in CHB provides a potential benefit in antiviral therapy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2024.1367265","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T05:08:02Z","timestamp":1710392882000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["High normal alanine aminotransferase is an indicator for better response to antiviral therapy in chronic hepatitis 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