ArticleThe American journal of gastroenterology2019
Phase Transition Is Infrequent Among North American Adults With e-Antigen-Negative Chronic Hepatitis B and Low-Level Viremia.
Article in The American journal of gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 32 citations in OpenAlex.
- HBV-miR-3 is closely related to HBV replication and strongly predictive of HBeAg seroconversion in PegIFN-α treated patients.Scientific reports · 2024Trial
- Hepatitis B Virus RNA Predicts Hepatocellular Carcinoma Despite Viral Suppression.Alimentary pharmacology & therapeutics · 2026Article
- Long-term outcomes of baseline grey-zone patients with HBeAg-negative chronic hepatitis B virus infection.JHEP reports : innovation in hepatology · 2026Article
- Indeterminate Phase/Grey Zone of Chronic Hepatitis B: Clinical Features, Outcomes and Molecular Insights.Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Prediction of long-term HBsAg seroclearance in patients with HBeAg-negative chronic hepatitis B.JHEP reports : innovation in hepatology · 2025Article
- Hepatocellular carcinoma among patients with chronic hepatitis B in the indeterminate phase.Journal of viral hepatitis · 2024Review
- Canadian Association for the Study of the Liver Single Topic Conference on Hepatitis B Virus: 'Progress toward hepatitis B elimination in Canada'.Canadian liver journal · 2024Article
- Interferon-α could induce liver steatosis to promote HBsAg loss by increasing triglyceride level.Heliyon · 2024Article
- HBcrAg-based risk score performs better than the HBV DNA-based scores for HCC prediction in grey zone patients who are HBeAg-negative.JHEP reports : innovation in hepatology · 2024Article
- [Natural history of chronic hepatitis B virus infection under low-level viremia].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- Liver Complications in Untreated Treatment-Ineligible versus Treated Treatment-Eligible Patients with Hepatitis B.Digestive diseases (Basel, Switzerland) · 2023Review
- HBeAg-negative Patients with Chronic Hepatitis B Virus Infection and Normal Alanine Aminotransferase: Wait or Treat?Journal of clinical and translational hepatology · 2022Review
- Different Kinetics of HBV-DNA and HBsAg in HCV Coinfected Patients during DAAs Therapy.Journal of clinical medicine · 2022Article
- Three heads are better than two: Hepatitis B core-related antigen as a new predictor of hepatitis B virus-related hepatocellular carcinoma.Clinical and molecular hepatology · 2021Review
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Authors and funding
14 authors at 12 institutions in 2 countries.
Funding
Abstract
introductionPatients with hepatitis B early antigen (HBeAg)-negative chronic hepatitis B (CHB) and low-level viremia are a heterogeneous group. Identifying those at risk of developing active CHB requiring antiviral therapy is important. In this study, we prospectively characterize incidence rates and predictors of transitioning from inactive to active CHB in a North American adult cohort.
methodsParticipants in the multicenter National Institute of Diabetes and Digestive and Kidney Diseases Hepatitis B Research Network cohort who were HBeAg negative with baseline hepatitis B virus (HBV) DNA ≤ 10,000 IU/mL were included in the study. Cox regression models were used to estimate the proportion of individuals in 3 baseline HBV DNA categories (≤100, 101 to ≤2,000, and 2,001 to ≤10,000 IU/mL) who developed phase transition defined by HBV DNA > 10,000 IU/mL and alanine aminotransferase (ALT) > 2× upper limit of normal or initiated treatment during follow-up.
resultsOf 970 participants meeting inclusion criteria, 15% experienced phase transition or initiated treatment over a median follow-up of 4 years: 9% of those with baseline HBV DNA ≤ 100 IU/mL, 14% with HBV DNA 101 to ≤2,000 IU/mL, and 24% with HBV DNA 2,001 to ≤10,000 IU/mL (P < 0.001). The overall rate of phase transition or treatment initiation was 7.6 per 100 person-years: 4.6 in those with HBV DNA ≤ 100 IU/mL, 6.8 in those with HBV DNA 101 to ≤2,000 IU/mL, and 12.2 in those with HBV DNA 2,001 to ≤10,000 IU/mL (P < 0.001). Factors independently associated with higher rate of phase transition or treatment initiation included HBV genotype B or C, higher baseline ALT and HBV DNA levels, lower platelet count, quantitative hepatitis B surface antigen > 1,000 IU/mL, and hyperlipidemia. Only higher ALT, higher HBV DNA, and lower platelets were associated with phase transition when patients starting treatment were censored. DISCUSSION: Most adults in this North American cohort with HBeAg-negative CHB and low-level viremia remained inactive and off treatment over 4 years. Transition from inactive to active CHB is infrequent and predominantly associated with viral rather than host factors.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.