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CN 22-1108/R
Volume 40 Issue 5
May  2024
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Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(5): 940-945

Serological features and liver histopathology of chronic hepatitis B patients with normal alanine aminotransferase

DOI: 10.12449/JCH240512
  • 1.

    Wuxi Clinical Medical College Affiliated to Nanjing Medical University，Wuxi，Jiangsu 214000，China

  • 2.

    Department of Hepatology，Wuxi Fifth People’s Hospital，Wuxi，Jiangsu 214000，China

Research funding:

Wuxi Medical Key Discipline Construction Project-Innovation Team (CXTD2021009);

Taihu Talent Program (20200803)

More Information
  • Corresponding author: LU Zhonghua， lu_z_h@126.com （ORCID： 0000-0002-5388-8301）
  • Received Date: 2023-08-04
  • Accepted Date: 2023-10-07
  • Published Date: 2024-05-25
    Abstract
  •   Objective  To investigate the liver histopathological features of chronic hepatitis B （CHB） patients with normal alanine aminotransferase （ALT） and their correlation with serological markers.  Methods  Clinical data were collected from 137 patients with normal ALT who were treated in Wuxi Fifth People’s Hospital from April 2018 to June 2021， and the differences in liver histopathology and serological markers were analyzed， as well as the correlation between liver histopathology and serological markers. The chi-square test was used for comparison of categorical data between groups， and the Kruskal-Wallis H test was used for comparison of data between multiple groups. A Spearman rank correlation test was performed， and logistic regression was used to perform the multivariate analysis.  Results  In the ALT ≤20 U/L， 20‍ ‍—‍ ‍29 U/L， and 30‍ ‍—‍ ‍40 U/L groups， the patients with significant inflammatory necrosis （≥G2） accounted for 57.4%， 53.4%， and 75%， respectively， and the patients with significant fibrosis （≥S2） accounted for 63.8%， 62.1%， and 75%， respectively. There was a significant difference in the degree of inflammatory necrosis between the patients with positive or negative HBeAg， the patients with different levels of serum HBV DNA， and the patients with different levels of serum HBV RNA （χ2=10.008， 6.911， and 7.946， all P<0.05）， and there was a significant difference in fibrosis stage between the patients with positive or negative HBeAg and the patients with different levels of serum HBV RNA （χ2=7.996 and 10.874， both P<0.05）. The degree of liver inflammation and fibrosis stage were not significantly correlated with serum HBV DNA （rs =0.024， P=0.785； rs =0.039， P=0.652）， while they were significantly correlated with serum HBV RNA （rs =0.222， P=0.009； rs =0.187， P=0.029）. The multivariate analysis showed that in CHB patients， positive HBeAg was an independent risk factor for inflammatory necrosis （odds ratio ［OR］=-0.302， 95% confidence interval ［CI］： -1.160 to 0.386， P=0.002） and fibrosis （OR=-0.387， 95%CI： -1.160 to 0.386， P=0.011）.  Conclusion  There are varying degrees of inflammatory necrosis and fibrosis in the liver of CHB patients with normal ALT， and positive HBeAg is independent risk factor for significant inflammatory necrosis and fibrosis in liver tissue of these patients.

     

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