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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 6
Jun.  2023
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Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(6): 1304-1307

Liver inflammation and fibrosis in HBV-infected patients with a low viral load

DOI: 10.3969/j.issn.1001-5256.2023.06.008
  • 1.

    Department of Difficult Hepatology, Ganzhou Fifth People's Hospital, Ganzhou, Jiangxi 341000, China

  • 2.

    Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China

Research funding:

Science and Technology Fund Project of Jiangxi Provincial Health Commission (202212322);

Ganzhou Science and Technology Bureau Fund Project (GZ2020ZSF294)

More Information
  • Corresponding author: JIANG Manlei, lffjml@163.com (ORCID: 0000-0003-0971-6219)
  • Received Date: 2022-10-27
  • Accepted Date: 2022-12-12
  • Published Date: 2023-06-20
    Abstract
  •   Objective  To investigate liver inflammation and fibrosis in patients with chronic HBV infection with a low viral load.  Methods  Among the HBsAg-positive patients who attended Ganzhou Fifth People's Hospital from April 2019 to June 2022, 41 patients with 20 IU/mL < HBV DNA < 2 000 IU/mL were selected and underwent the examinations of blood biochemistry, liver stiffness measurement (LSM), and liver biopsy to clarify liver inflammation and fibrosis. Liver inflammation was analyzed according to HBV DNA, alanine aminotransferase (ALT), LSM, and age. The chi-square test was used for comparison of categorical data between groups.  Results  Among the 41 patients, 15 (36.59%) had liver inflammation grade ≥G2 and/or liver fibrosis stage ≥S2. Among these 15 patients, 11 (73.33%) had an HBV DNA level of > 200-2 000 IU/mL and 4 (26.67%) had an HBV DNA level of 20-200 IU/mL; the patients with G2 liver inflammation accounted for 73.33% (11/15), and those with S2 liver fibrosis accounted for 46.67% (7/15); the patients with ALT ≤30 U/L accounted for 46.67% (7/15); the patients aged ≥30 years accounted for 86.66% (13/15); the patients with LSM > 17 kPa accounted for 6.67% (1/15), those with an LSM value of 12.4-17 kPa accounted for 46.67% (7/15), and those with an LSM value of 9.4-12.4 kPa accounted for 33.33% (5/15).  Conclusion  Patients with chronic HBV infection and low-level viremia have a relatively high risk of progression of inflammation and fibrosis. ALT level cannot be used as a basis for antiviral therapy in HBV-infected people with a low viral load. LSM based on transient elastography can be used as a noninvasive test to screen for CHB patients with a low viral load, and antiviral therapy should be considered when HBV-infected patients with a low viral load have an age of > 30 years and an LSM value of > 9.4 kPa persistently.

     

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