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However, the gray zone CHB patients with significant hepatitis B virus levels (&gt;2000 IU\/mL) and persistently normal alanine aminotransferase (ALT) levels have a significantly high risk of hepatic inflammation, fibrosis, and hepatocellular carcinoma. The molecular, clinical, and economic data that we have reviewed collectively in this article provide support for simplification of treatment initiation strategies that incorporate broader treatment of adult patients with CHB in the gray zone (hepatitis B virus [HBV] DNA \u22652000 IU\/mL), regardless of ALT levels.<\/jats:p>","DOI":"10.4103\/sjg.sjg_279_23","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T09:09:34Z","timestamp":1696928974000},"page":"76-82","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Gray zone of hepatitis B virus infection"],"prefix":"10.4103","volume":"30","author":[{"given":"Young-Suk","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of 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