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Review
. 2022 Oct 28;10(5):972-978.
doi: 10.14218/JCTH.2021.00443. Epub 2022 Mar 17.

HBeAg-negative Patients with Chronic Hepatitis B Virus Infection and Normal Alanine Aminotransferase: Wait or Treat?

Qiuju Sheng  1 , Ning Wang  1 , Chong Zhang  1 , Yaoxin Fan  1 , Yanwei Li  1 , Chao Han  1 , Ziyi Wang  1 , Shuqi Wei  1 , Xiaoguang Dou  1 , Yang Ding  1
Affiliations
Review

HBeAg-negative Patients with Chronic Hepatitis B Virus Infection and Normal Alanine Aminotransferase: Wait or Treat?

Qiuju Sheng et al. J Clin Transl Hepatol. .

Abstract

Alanine aminotransferase (ALT) is a common clinical indicator of liver inflammation. The current Chinese guidelines for the management of chronic hepatitis B (CHB) recommend antiviral treatment for patients with detectable hepatitis B virus (HBV) DNA and persistent ALT levels (ALTs) exceeding the upper limit of normal. However, it has been recently reported that patients with chronic HBV infection, especially HBeAg-negative patients with persistently normal ALTs, may have liver biopsy findings of significant inflammation and fibrosis. For HBeAg-negative patients with chronic HBV infection and normal ALTs, many controversial questions have been asked. To treat or not? When to initiate the treatment? Which drug is appropriate? In this review, we summarize the available data on the management of HBeAg-negative patients with chronic HBV infection and normal ALTs with the aim of improving the current clinical management.

Keywords: Alanine aminotransferase; Antiviral therapy; Chronic hepatitis B; Hepatitis B virus; Hepatitis e antigen.

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Conflict of interest statement

XD has been an associate editor of Journal of Clinical and Translational Hepatology since 2013. The other authors have no conflict of interests related to this publication.

Figures

Fig. 1
Fig. 1. Algorithm for the management of HBeAg-negative patients with chronic HBV infection and normal alanine aminotransferase.
HBV, hepatitis B virus.
See this image and copyright information in PMC

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