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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2023; 29(35): 5166-5177
Published online Sep 21, 2023. doi: 10.3748/wjg.v29.i35.5166
Published online Sep 21, 2023. doi: 10.3748/wjg.v29.i35.5166
Lowering the threshold of alanine aminotransferase for enhanced identification of significant hepatic injury in chronic hepatitis B patients
Hong-Sheng Yu, Hao Jiang, Ming-Kai Li, Bi-Lan Yang, Abdukyamu Smayi, Bin Wu, Yi-Dong Yang, Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Hong-Sheng Yu, Hao Jiang, Ming-Kai Li, Bi-Lan Yang, Abdukyamu Smayi, Bin Wu, Yi-Dong Yang, Department of Liver Disease, Guangdong Provincial Key Laboratory of Liver Disease Research, Guangzhou 510630, Guangdong Province, China
Jian-Ning Chen, Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Author contributions: Yu HS and Jiang H have contributed equally to this work; Yu HS and Jiang H designed the study, performed the statistical analysis, and drafted the manuscript; Li MK, Yang BL, Smayi A and Chen JN collected the clinical data and then reviewed the data; Wu B and Yang YD revised the manuscript; Yang YD and Wu B were responsible for the study conception, design, data, analysis; All authors have read and approved the manuscript.
Supported by The Natural Science Foundation of Guangdong Province for Distinguished Young Scholar , No. 2022B1515020024 ; National Natural Science Foundation of China , No. 82070574 ; and The Natural Science Foundation Team Project of Guangdong Province , No. 2018B030312009 .
Institutional review board statement: The study was reviewed and approved by the Third Affiliated Hospital of Sun Yat-Sen University. No. [2019]02-530-01.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Dong Yang, PhD, Associate Professor, Department of Gastroyangyd6@mail.sysu.edu.cn
Received: July 2, 2023
Peer-review started: July 2, 2023
First decision: July 14, 2023
Revised: July 22, 2023
Accepted: August 31, 2023
Article in press: August 31, 2023
Published online: September 21, 2023
Peer-review started: July 2, 2023
First decision: July 14, 2023
Revised: July 22, 2023
Accepted: August 31, 2023
Article in press: August 31, 2023
Published online: September 21, 2023
Core Tip
Core Tip: In clinical practice, 27.8%-55% of chronic hepatitis B patients fall into the “grey zone” or “indeterminate phase” that does not meet the diagnostic criteria of the traditional stages. Additionally, there is still debate regarding how best to treat these grey zone (GZ) patients and the advantages of antiviral therapy. Hence, we evaluated the clinical and histological characteristics, and additionally explored the impact of adjusting the threshold of alanine aminotransferase (ALT) in identifying significant liver injury among GZ patients. Based on these data, lowering ALT thresholds can more accurately identify patients with significant hepatic injury at an earlier stage and reduce the need for unnecessary liver biopsies.