What question did this study set out to answer?

This research aims to evaluate the necessity of antiviral treatment for chronic hepatitis B patients with normal ALT levels across different phases.

March 13, 2026Open Access

Histopathological Evaluation and Treatment Necessity in Patients with Immune-Tolerant, Inactive, and Gray-Zone Chronic Hepatitis B

Key Points

This research aims to evaluate the necessity of antiviral treatment for chronic hepatitis B patients with normal ALT levels across different phases.
Retrospective cross-sectional analysis
Included immune-tolerant HBeAg-positive, inactive HBeAg-negative, and gray-zone patients
Assessed liver fibrosis stage and histological activity index (HAI)
Identified distinct liver conditions among immune-tolerant, inactive, and gray-zone patients
Determined the need for antiviral therapy based on liver fibrosis and HAI scores

Abstract

Objective: To evaluate the need for antiviral therapy in chronic hepatitis B (CHB) patients with normal ALT levels who are HBeAg-positive (Immune tolerant phase), HBeAg-negative (Inactive phase), or in the gray-zone, by assessing liver fibrosis stage and histological activity index (HAI).Methods: This retrospective cross-sectional study included 36 immune-tolerant HBeAg-positive, 21 inactive HBeAg-negative, and 193 gray-zone CHB patients without prior antiviral therapy. The inactive phase was defined as persistently normal ALT and HBV DNA

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Histopathological Evaluation and Treatment Necessity in Patients with Immune-Tolerant, Inactive, and Gray-Zone Chronic Hepatitis B

Key Points

Abstract

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