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The treatment of chronic hepatitis B (CHB) depends on the level of viralemia, the severity of liver fibrosis and the severity of liver inflammation.
for liver inflammation, blood glutamate transaminase (ALT) levels are widely used for risk stratation, however, studies have shown a limited correlation between serum ALT levels and histological activity.
This limitation is particularly important for patients with hepatitis B virus (HBV) DNA levels above the treatment threshold and no visible signs of liver fibrosis, as the degree of inflammatory activity will be the main determinant of the onion of hepatitis resistance.
, the purpose of this study was to assess the likelihood of significant liver inflammation in patients with lower ALT levels, especially those without significant liver fibrosis.
researchers selected patients with HBV DNA and 2000 IU/mL from a forward-looking database to be included in the study.
to assess the presence of severe inflammation through liver biopsies (METAVIR score of A2 or HAI score of 9) and correlation analysis with alanine amino transferase (ALT) levels.
the study included 2,991 patients and 1,672 patients who were HBeAg-positive.
270 patients with ALT less than the normal upper limit (ULN), 852 more than ULN1-2 times, and 186 patients who were more than Twice the normal value limit (ULN).
found significant fibrosis in 1,419 patients and significant inflammatory activity in 630 patients.
34 percent of patients with liver fibrosis found significant inflammatory activity, while 9.5 percent of patients without liver fibrosis had significant inflammatory activity ( P .lt;0.001).
in patients without fibrosis, 3.6 percent of patients with normal ALT detected significant inflammatory activity, 5.0 percent of patients with ALT 1 to 2 times ULN, and 13 percent of patients with 2 times as much ALT.
95% negative predictive of significant inflammatory activity in patients with liver fibrosis excluded from ALT and lt;2 ULN.
, the researchers said, ALT levels were levels in patients without significant fibrosis.
