48-week prognostic analysis of very low-level viremia in patients with hepatitis B cirrhosis: a single-center retrospective study
ObjectiveDespite improvements in the accuracy of hepatitis B virus (HBV) DNA detection, some patients with chronic hepatitis B (CHB) still have very low-level viremia (VLLV; HBV DNA is detectable but less than 20 IU/mL) after achieving a complete virologic response (CVR). This study aimed to investi...
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Frontiers Media S.A.
2025-07-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1549791/full |
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| author | Yinong Feng Zehong Wang Shaoyuan Shi Li Zhou Yongli Hua Xuanxuan Wang Jianzhong Ma |
| author_facet | Yinong Feng Zehong Wang Shaoyuan Shi Li Zhou Yongli Hua Xuanxuan Wang Jianzhong Ma |
| author_sort | Yinong Feng |
| collection | DOAJ |
| description | ObjectiveDespite improvements in the accuracy of hepatitis B virus (HBV) DNA detection, some patients with chronic hepatitis B (CHB) still have very low-level viremia (VLLV; HBV DNA is detectable but less than 20 IU/mL) after achieving a complete virologic response (CVR). This study aimed to investigate the prognosis of patients with cirrhotic hepatitis B and VLLV.MethodsA total of 267 patients with hepatitis B cirrhosis from the Third People’s Hospital of Taiyuan were retrospectively enrolled. All patients took oral antiviral drugs for more than 96 weeks and were divided into the target not-detected group (TND; HBV DNA undetectable) and the VLLV group (limits of detection < HBV DNA < 20 IU/mL) by high-sensitivity testing of HBV. The incidence of cirrhosis-related complications was observed.ResultsCompared to the TND group, the baseline levels of alanine aminotransferase (ALT; 20.0 vs. 26.0 U/L, p < 0.001), aspartate aminotransferase (AST; 24.0 vs. 27.5 U/L, p < 0.001), and gamma-glutamyl transferase (GGT; 21.0 vs. 30.5 U/L, p = 0.001) were significantly higher in the VLLV group, and so were liver stiffness values (9.4 vs. 10.8 kPa, p = 0.006). No significant difference was observed in the rate of new cirrhosis-related complications between the two groups. The HCC rate was 5.4% in TND and 4.7% in the VLLV (p > 0.05). Multifactorial logistic regression showed that the main factors affecting complications at baseline were age (OR:1.063; p = 0.034), hemoglobin level (OR:0.965; p = 0.036), and platelet count (OR:0.987; p = 0.029).ConclusionFor cirrhotic patients with VLLV, the lower the level of HBV DNA, the less severe the liver injury. There was no difference in the 48-week complication rates between the TND group. Even in the TND group, which can develop new complications, regular follow-up should be performed. |
| format | Article |
| id | doaj-art-df3372db056242c382d187598ea58e7e |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-07-01 |
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| spelling | doaj-art-df3372db056242c382d187598ea58e7e2025-08-20T03:33:21ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.1549791154979148-week prognostic analysis of very low-level viremia in patients with hepatitis B cirrhosis: a single-center retrospective studyYinong Feng0Zehong Wang1Shaoyuan Shi2Li Zhou3Yongli Hua4Xuanxuan Wang5Jianzhong Ma6Department of Hepatology, The Third People’s Hospital of Taiyuan, Taiyuan, ChinaDepartment of Hepatology, The Third People’s Hospital of Taiyuan, Taiyuan, ChinaDepartment of Hepatology, The Third People’s Hospital of Taiyuan, Taiyuan, ChinaDepartment of Hepatology, The Third People’s Hospital of Taiyuan, Taiyuan, ChinaDepartment of Hepatology, The Third People’s Hospital of Taiyuan, Taiyuan, ChinaDepartment of Hepatology, The Third People’s Hospital of Taiyuan, Taiyuan, ChinaScience and Education Department, The Third People’s Hospital of Taiyuan, Taiyuan, ChinaObjectiveDespite improvements in the accuracy of hepatitis B virus (HBV) DNA detection, some patients with chronic hepatitis B (CHB) still have very low-level viremia (VLLV; HBV DNA is detectable but less than 20 IU/mL) after achieving a complete virologic response (CVR). This study aimed to investigate the prognosis of patients with cirrhotic hepatitis B and VLLV.MethodsA total of 267 patients with hepatitis B cirrhosis from the Third People’s Hospital of Taiyuan were retrospectively enrolled. All patients took oral antiviral drugs for more than 96 weeks and were divided into the target not-detected group (TND; HBV DNA undetectable) and the VLLV group (limits of detection < HBV DNA < 20 IU/mL) by high-sensitivity testing of HBV. The incidence of cirrhosis-related complications was observed.ResultsCompared to the TND group, the baseline levels of alanine aminotransferase (ALT; 20.0 vs. 26.0 U/L, p < 0.001), aspartate aminotransferase (AST; 24.0 vs. 27.5 U/L, p < 0.001), and gamma-glutamyl transferase (GGT; 21.0 vs. 30.5 U/L, p = 0.001) were significantly higher in the VLLV group, and so were liver stiffness values (9.4 vs. 10.8 kPa, p = 0.006). No significant difference was observed in the rate of new cirrhosis-related complications between the two groups. The HCC rate was 5.4% in TND and 4.7% in the VLLV (p > 0.05). Multifactorial logistic regression showed that the main factors affecting complications at baseline were age (OR:1.063; p = 0.034), hemoglobin level (OR:0.965; p = 0.036), and platelet count (OR:0.987; p = 0.029).ConclusionFor cirrhotic patients with VLLV, the lower the level of HBV DNA, the less severe the liver injury. There was no difference in the 48-week complication rates between the TND group. Even in the TND group, which can develop new complications, regular follow-up should be performed.https://www.frontiersin.org/articles/10.3389/fmed.2025.1549791/fullchronic hepatitis Bcirrhosishepatocellular carcinomahigh sensitivity of HBV DNA detectionvery low-level viremia |
| spellingShingle | Yinong Feng Zehong Wang Shaoyuan Shi Li Zhou Yongli Hua Xuanxuan Wang Jianzhong Ma 48-week prognostic analysis of very low-level viremia in patients with hepatitis B cirrhosis: a single-center retrospective study Frontiers in Medicine chronic hepatitis B cirrhosis hepatocellular carcinoma high sensitivity of HBV DNA detection very low-level viremia |
| title | 48-week prognostic analysis of very low-level viremia in patients with hepatitis B cirrhosis: a single-center retrospective study |
| title_full | 48-week prognostic analysis of very low-level viremia in patients with hepatitis B cirrhosis: a single-center retrospective study |
| title_fullStr | 48-week prognostic analysis of very low-level viremia in patients with hepatitis B cirrhosis: a single-center retrospective study |
| title_full_unstemmed | 48-week prognostic analysis of very low-level viremia in patients with hepatitis B cirrhosis: a single-center retrospective study |
| title_short | 48-week prognostic analysis of very low-level viremia in patients with hepatitis B cirrhosis: a single-center retrospective study |
| title_sort | 48 week prognostic analysis of very low level viremia in patients with hepatitis b cirrhosis a single center retrospective study |
| topic | chronic hepatitis B cirrhosis hepatocellular carcinoma high sensitivity of HBV DNA detection very low-level viremia |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1549791/full |
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