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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Main Authors: Yinong Feng, Zehong Wang, Shaoyuan Shi, Li Zhou, Yongli Hua, Xuanxuan Wang, Jianzhong Ma
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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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.
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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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