Turkish Journal of Gastroenterology
Original Articles

Histopathological Features and Antiviral Efficacy in Patients Over 30 Years Old with Chronic Hepatitis B in the Indeterminate Phase

1.

Department of Infectious Disease and Liver Disease, the Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Jiangsu, China

2.

The Clinical Infectious Disease Center of Nanjing, Jiangsu, China

3.

Clinical Research Center, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Jiangsu, China

Turk J Gastroenterol 2025; 1: -
DOI: 10.5152/tjg.2025.25138
Read: 21 Downloads: 9 Published: 03 October 2025

Background/Aims: There are still many controversies about whether antiviral therapy should be administered to patients with chronic hepatitis B (CHB) in the indeterminate phase. Thus, this study aimed to investigate the histopathological features and antiviral efficacy of HBeAg-negative CHB patients aged over 30 in the indeterminate phase.

Materials and Methods: The clinical, laboratory, and histopathological characteristics of 666 CHB patients were assessed through a retrospective study. To identify factors associated with significant liver inflammation and fibrosis, inter-group differential analysis and binary logistic regression were conducted. Receiver operating characteristic curve analysis was used to determine the area under the curve and optimal cut-off values for relevant indicators. The antiviral efficacy was analyzed in 62 patients who received antiviral treatment by inter-group differential analysis.

Results: A total of 70 patients were enrolled in the study. The median age was 40.5 years and 38 patients (54.28%) were male. Significant liver inflammation and significant liver fibrosis represented 30% and 55.7% of the patient cohort, respectively. Multivariate logistic regression analysis revealed that red blood cell count (RBC) and aspartate aminotransferase (AST) were independent predictors of significant liver inflammation (odds ratio [OR] (95%CI): 0.34 (0.13,0.90), P = .03; OR (95%CI): 1.19 (1.05,1.34), P = .006). Aspartate aminotransferase was also an independent predictor of significant liver fibrosis (OR (95%CI): 1.24 (1.06,1.47), P = .01). The negative conversion rate of hepatitis B virus (HBV) DNA was above 80% from 24 weeks after antiviral treatment, and low-level viremia (LLV) accounted for 6.5% (4/62) at 48 weeks after antiviral treatment.

Conclusion: Among HBeAg-negative CHB patients aged over 30 in the indeterminate phase, over half had significant liver inflammation or fibrosis. In addition, RBC was a protective factor for significant liver inflammation, and AST was a risk factor for significant liver inflammation and fibrosis in such patients. Notably, antiviral treatment was effective. However, long-term monitoring of HBV DNA and the occurrence of LLV and drug resistance should be conducted during treatment.

 

Cite this article as: Ou K, Ma Y, Yuan C, et al. Histopathological Features and Antiviral Efficacy in Patients Over 30 Years Old with Chronic Hepatitis B in the Indeterminate Phase. Turk J Gastroenterol. Published online October 3, 2025. doi 10.5152/tjg.2025.25138.

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