Liver histopathological lesions is severe in patients with normal alanine transaminase and low to moderate hepatitis B virus DNA replication

Table 4 Predictors of significant liver histology in propensity score-matched pairs

Variables	EASL guidelines (316 pairs)				CMA guidelines (277 pairs)
	≥ A2 or/and ≥ F2	< A2 and < F2	χ2/t/Z	SMD	≥ A2 or/and ≥ F2	< A2 and < F2	χ2/t/Z	SMD
Male, n (%)	171 (54.11)	168 (53.16)	0.057	0.811	138 (49.82)	153 (55.23)	1.629	0.202
HBeAg positive, n (%)	305 (96.52)	306 (96.84)	0.049	0.824	271 (97.83)	271 (97.83)	0	1.000
Age, mean ± SD, yr	32.92 ± 10.13	33.06 ± 9.96	-0.178	0.859	32.54 ± 9.04	33.31 ± 10.07	-0.937	0.349
ALB, mean ± SD, g/L	42.30 ± 4.59	42.65 ± 3.78	-1.046	0.296	42.35 ± 4.81	42.79 ± 3.76	-1.187	0.236
GLB, mean ± SD, g/L	27.74 ± 4.83	27.74 ± 4.26	0.019	0.985	27.23 ± 4.56	27.53 ± 4.25	-0.809	0.419
AGR, mean ± SD	1.57 ± 0.33	1.57 ± 0.28	-0.037	0.971	1.59 ± 0.29	1.59 ± 0.28	0.198	0.843
ALT, mean ± SD, U/L	23.81 ± 8.29	22.78 ± 8.29	1.569	0.117	23.18 ± 9.10	23.00 ± 8.38	0.235	0.814
AST, mean ± SD, U/L	22.13 ± 8.55	22.57 ± 5.76	-0.769	0.442	21.87 ± 7.74	22.72 ± 5.70	-1.465	0.143
ALP, mean ± SD, U/L	71.64 ± 27.61	70.56 ± 27.09	0.495	0.621	72.15 ± 25.92	71.37 ± 27.39	0.345	0.730
GGT, median (Q1-Q3), U/L	16.00 (13.00–23.00)	16.00 (13.00–23.00)	0.780	0.435	16.00 (13.00-24.00)	17.00 (13.00-23.00)	0.590	0.555
WBC count, mean ± SD, ×109/L	5.44 ± 1.27	5.47 ± 1.38	-0.276	0.783	5.51 ± 1.31	5.48 ± 1.30	0.274	0.784
NLR, mean ± SD	1.91 ± 0.80	2.01 ± 1.04	-1.431	0.153	1.89 ± 1.01	2.00 ± 1.04	-1.334	0.183
PLT count, mean ± SD, ×109/L	183.43 ± 42.01	187.96 ± 47.38	-1.272	0.204	184.38 ± 49.39	187.11 ± 48.08	-0.659	0.510
HBV DNA, mean ± SD, log IU/mL	5.81 ± 1.23	7.90 ± 0.49	-27.967	< 0.001	5.78 ± 1.42	8.01 ± 0.43	-24.922	< 0.001
APRI, median (Q1– Q3)	0.31 (0.23-0.38)	0.29 (0.23-0.38)	0.507	0.612	0.32 (0.22–0.39)	0.30 (0.23-0.38)	-0.147	0.883
FIB-4, median (Q1–Q3)	0.80 (0.49-1.11)	0.80 (0.58-1.12)	1.460	0.144	0.74 (0.50-1.17)	0.82 (0.59-1.13)	-1.110	0.267
LIF-5, mean ± SD	0.37 ± 0.14	0.36 ± 0.14	0.903	0.367	0.35 ± 0.14	0.36± 0.14	-0.187	0.852

Low/moderate replication, hepatitis B virus (HBV) DNA ≤ 10⁷ IU/mL; high replication, HBV DNA > 10⁷ IU/mL. Quantitative data of normal distribution were expressed as mean ± standard deviation, non-normal distribution data were expressed as median (Q1-Q3), and categorical data were expressed as frequency and percentage. AGR: Albumin–globulin ratio; ALB: Albumin; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; APRI: Aspartate transaminase to platelet ratio index, APRI = [(AST/ULN)/platelet counts (10⁹/L)] × 100[16]; AST: Aspartate aminotransferase; CMA: Chinese Medical Association; EASL: European Association for the Study of the Liver; F: Liver fibrosis; GLB: Globulin; FIB-4: Fibrosis-4, FIB-4 = [age (year) × AST (U/L)]/(platelet count (10⁹/L) × [ALT (U/L)^1/2][17]; GGT: Gamma-glutamyl transpeptidase; HBeAg: Hepatitis B e antigen; LIF-5: Liver inflammation and fibrosis-5, LIF-5 = 0.725 + 0.005 × age (year) + 0.003 × ALT (U/L) + 0.004 × AST (U/L) - 0.201 × (A/G) - 0.002 × PLT (10⁹/L)[18]; NLR: Neutrophils lymphocytes ratio; PLT: Platelets; WBC: White blood cell; HBV: Hepatitis B virus.