Evaluation of Antiviral Indications on Chronic HBV Infection With Different Transaminase Levels
Evaluation of Antiviral Indications on Chronic HBV Infection With Different Transaminase Levels
It remains unknown whether antiviral therapy is beneficial for chronic hepatitis B (CHB) with
 normal or mild ALT.The investigators aim to evaluate the antiviral indications combining
 liver biopsy and clinical parameters,and further clarify the response indexes of clinical
 results such as virological, serological, biochemical and histological responses from a
 retrospective observational cohort study on antiviral therapy in HBeAg positive and negative
 patients with different ALT levels,especially when ALT lower 2 times upper limit of normal
 (ULN).
It is estimated that 400 million people worldwide are chronically infected with hepatitis B
 virus (HBV).Chronic hepatitis B (CHB) often leads to serious health conditions including
 decompensated liver cirrhosis and hepatocellular carcinoma (HCC). Therefore, the goal of
 chronic hepatitis B (CHB) therapy is to achieve sustained suppression of HBV replication and
 remission of liver disease.Clinical CHB management guidelines suggest recommend threshold for
 antiviral therapy when ALT was more than 2 times ULN.No antiviral drugs are recommended for
 patients with normal ALT or mildly elevated ALT unless they exhibit symptoms of advanced
 fibrosis or liver cirrhosis.But chronic HBV infections with normal or mild ALT levels may
 develop latently into CHB,even cirrhosis and hepatocellular carcinoma (HCC).The ALT level is
 easily influenced by many factors.Antiviral therapy may still be needed for some HBV patients
 with normal or mildly abnormal ALT levels. Therefore, the investigator's purpose is to
 evaluate of antiviral indications and therapeutic effect by liver biopsy and clinical trial
 parameters on chronic HBV infection with different ALT levels,especially when ALT lower 2
 times upper limit of normal (ULN).
Inclusion Criteria:All of below

 1. Patients with chronic HBV infection,defined as those in whom presence of serum
 hepatitis B surface(HBsAg) for more than 6 months;

 2. All patients had underwent a liver biopsy;

 3. All patients signed the informed consent before liver biopsy;

 4. No history use of interferon or Nucleoside analogue treatment.

 Exclusion Criteria:Any of below

 1. Co-infection with hepatitis A virus(HAV),hepatitis C virus(HCV),hepatitis D virus(HDV)
 hepatitis E virus(HEV) and/or human immunodeficiency virus(HIV);

 2. Decompensated cirrhosis;

 3. History of hepatocellular carcinoma(HCC);

 4. History of liver transplantation;

 5. Patient with a history of antiviral treatment;

 6. Patient has medical condition that requires concurrent use of systemic prednisolone or
 other immunosuppressive agent (including chemotherapeutic agent)

 7. Patient has one or more additional known primary or secondary causes of liver disease,
 other than hepatitis B (e.g., alcoholism, autoimmune hepatitis, malignancy with
 hepatic involvement, hemochromatosis,alpha-1 antitrypsin deficiency, Wilson's Disease,
 other congenital or metabolic conditions affecting the liver, congestive heart failure
 or other severe cardiopulmonary disease, etc.)

 8. Patient who interrupted antiviral therapy;

 9. Patient with incomplete data;

 10. Follow up less than 1 year.