Sheng Qiuju, Wang Ning, Zhang Chong, Fan Yaoxin, Li Yanwei, Han Chao, Wang Ziyi, Wei Shuqi, Dou Xiaoguang, Ding Yang
Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
J Clin Transl Hepatol. 2022 Oct 28;10(5):972-978. doi: 10.14218/JCTH.2021.00443. Epub 2022 Mar 17.
Alanine aminotransferase (ALT) is a common clinical indicator of liver inflammation. The current Chinese guidelines for the management of chronic hepatitis B (CHB) recommend antiviral treatment for patients with detectable hepatitis B virus (HBV) DNA and persistent ALT levels (ALTs) exceeding the upper limit of normal. However, it has been recently reported that patients with chronic HBV infection, especially HBeAg-negative patients with persistently normal ALTs, may have liver biopsy findings of significant inflammation and fibrosis. For HBeAg-negative patients with chronic HBV infection and normal ALTs, many controversial questions have been asked. To treat or not? When to initiate the treatment? Which drug is appropriate? In this review, we summarize the available data on the management of HBeAg-negative patients with chronic HBV infection and normal ALTs with the aim of improving the current clinical management.
丙氨酸氨基转移酶（ALT）是肝脏炎症的常见临床指标。现行的中国慢性乙型肝炎（CHB）防治指南推荐，对于可检测到乙肝病毒（HBV）DNA且ALT持续水平超过正常上限的患者进行抗病毒治疗。然而，最近有报道称，慢性HBV感染患者，尤其是ALT持续正常的HBeAg阴性患者，肝脏活检可能显示有显著的炎症和纤维化。对于ALT正常的慢性HBV感染HBeAg阴性患者，人们提出了许多有争议的问题。是否治疗？何时开始治疗？哪种药物合适？在本综述中，我们总结了关于ALT正常的慢性HBV感染HBeAg阴性患者管理的现有数据，旨在改善当前的临床管理。
