Evidence map›Paper›PMID 36070707›Full record

ReviewDigestive diseases (Basel, Switzerland)2023

Liver Complications in Untreated Treatment-Ineligible versus Treated Treatment-Eligible Patients with Hepatitis B.

Daniel Q Huang, Dong Hyun Lee, Michael H Le, An Le, Yee Hui Yeo, Huy N Trinh, Mimi Chung, Vy Nguyen, Tiffani Johnson, Jian Q Zhang and 5 more

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Digestive diseases (Basel, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 18 citations in OpenAlex.

  1. 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 · 2026
    Review
  2. Review
  3. Review
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 2 countries.

Daniel Q HuangDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Dong Hyun LeeDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, Good Gang-An Hospital, Busan, Republic of Korea.
Michael H LeDivision of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.
An LeDivision of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.
Yee Hui YeoDivision of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.
Huy N TrinhSan Jose Gastroenterology, San Jose, California, USA.
Mimi ChungIcahn School of Medicine at Mount Sinai, New York, New York, USA.
Vy NguyenDivision of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.
Tiffani JohnsonUniversity of California, Berkeley, Berkeley, California, USA.
Jian Q ZhangChinese Hospital, San Francisco, California, USA.
Clifford WongWong Clinics, San Francisco, California, USA.
Christopher WongWong Clinics, San Francisco, California, USA.
Jiayi LiPalo Alto Medical Foundation, Mountain View Division, Mountain View, California, USA.
Ramsey CheungDivision of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.
Mindie H NguyenDivision of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.
Stanford Medicine · USIcahn School of Medicine at Mount Sinai · USNational University of Singapore · SGUniversity of California, Berkeley · USVA Palo Alto Health Care System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA substantial number of patients who do not meet treatment criteria for chronic hepatitis B (CHB) later develop adverse outcomes such as cirrhosis and hepatocellular carcinoma (HCC). Our aim was to determine whether current practice guidelines adequately identify CHB patients who will benefit from antiviral therapy.

methodsWe performed a retrospective cohort study comparing the incidence of adverse liver outcomes (cirrhosis and/or HCC) in untreated treatment-ineligible (at baseline and throughout follow-up) versus treated treatment-eligible patients according to standard American Association for the Study of Liver Diseases (AASLD) 2018 guidance (alanine aminotransferase [ALT] >70/50 U/L for men/women plus hepatitis B virus [HBV] DNA >20,000/2,000 IU/mL for HBeAg+/-) and with a sensitivity analyses using a lower threshold (ALT >40 U/L and HBV DNA >2,000 IU/mL).

resultsWe reviewed records of 5,840 patients from 5 clinics in California and identified 2,987 treatment-naive non-HCC CHB patients. Of those, 271 patients remained untreated treatment-ineligible, 514 patients were treatment-eligible and initiated treatment, with 5-year cumulative adverse liver incidences of 12.5% versus 7.2%, p = 0.074. On multivariable analysis adjusting for age, sex, diabetes, albumin, platelet count, and HBV DNA, compared to treated treatment-eligible patients, untreated treatment-ineligible patients had a significantly higher risk of adverse liver outcomes (adjusted hazard ratio: 2.38, 95% confidence interval 1.03-5.48, p = 0.04) in main analysis by AASLD 2018 criteria but not in sensitivity analysis using the lower treatment threshold (p = 0.09).

conclusionPatients never meeting standard AASLD 2018 criteria for antiviral therapy and never treated had twice the risk of developing cirrhosis and/or HCC when compared to eligible and treated patients.

Indexed as

Carcinoma, HepatocellularHepatitis B, ChronicLiver NeoplasmsAntiviral AgentsDNA, ViralFemaleHepatitis B e AntigensHepatitis B virusHumansLiver CirrhosisMaleRetrospective StudiesAntiviral AgentsDNA, ViralHepatitis B e AntigensAntiviral therapyHepatocellular carcinomaLiver cirrhosisTreatment guidelines

Identifiers

PMID36070707
PMCPMC9909719
OpenAlexW4294908578

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.