New progress on diagnosis and treatment for indeterminate-phase chronic hepatitis B virus-infected patients
10.3760/cma.j.cn501113-20231129-00252
- VernacularTitle:不确定期慢性乙型肝炎病毒感染者的诊疗新进展
- Author:
Jiacheng LIU
1
;
Chao WU
;
Jie LI
Author Information
1. 南京大学医学院附属鼓楼医院感染性疾病科，南京 210008
- Keywords:
Chronic hepatitis B;
Antiviral therapy;
Alanine aminotransferase
- From:
Chinese Journal of Hepatology
2024;32(4):370-374
- CountryChina
- Language:Chinese
-
Abstract:
Authoritative guidelines at home and abroad typically classify chronic hepatitis B virus (HBV) infection into four stages. However, in clinical practice, a considerable number of patients do not meet the guidelines for staging and are called "indeterminate phase" chronic HBV- infected patients. Studies have shown that patients in the indeterminate phase account for about 30%–50% of chronic HBV infection, have significant liver histological changes or even cirrhosis in a large proportion, and are at a higher risk of HCC and death if they do not receive antiviral therapy. Preliminary research shows that patients in the indeterminate phase who receive antiviral treatment have a good virological response and a remarkable reduced HCC risk. To this end, the 2022 publication "Expert Opinions on Expanding Antiviral Treatment for Chronic Hepatitis B" recommends aggressive treatment for patients with an indeterminate phase who have undergone more than a year of follow-up. However, there is still a lack of unified standards to refine the classification, as well as a lack of effective and rapid non-invasive diagnostic methods to identify patients in the indeterminate phase who are at risk for disease progression. This article aims to review the researches on the proportion, clinical characteristics, disease progression, and treatment benefits to further explore how to better manage indeterminate-phase chronic HBV-infected patients.
