Histologic changes in immune-tolerant patients with chronic hepatitis B: a systematic review and meta-analysis
Abstract The serological diagnostic criteria for the immune-tolerant (IT) phase have not been strictly defined and it is hard to determine an accurate rate for significant histologic changes among IT patients. The aim of this study was to establish a baseline rate of significant histologic changes a...
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| Format: | Article |
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Nature Portfolio
2023-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-27545-z |
| _version_ | 1828063761201627136 |
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| author | Zhiguo Li Dongliang Yang Yue Ge Shu Song Qin Lv Yong’an Ye |
| author_facet | Zhiguo Li Dongliang Yang Yue Ge Shu Song Qin Lv Yong’an Ye |
| author_sort | Zhiguo Li |
| collection | DOAJ |
| description | Abstract The serological diagnostic criteria for the immune-tolerant (IT) phase have not been strictly defined and it is hard to determine an accurate rate for significant histologic changes among IT patients. The aim of this study was to establish a baseline rate of significant histologic changes and to determine the main characteristics of IT patients. We systematically searched PubMed, Embase, and Web of Science. Studies reporting liver biopsy results (inflammation grade or fibrosis stage) for adults with chronic hepatitis B virus (HBV) infection in the IT phase diagnosed by serological criterion were included to pool the rate of significant histologic changes. Studies that enrolled subjects with confirmed chronic HBV infection in the IT phase diagnosed by serological and liver biopsy criteria (dual criteria) were included to pool the mean values of main characteristics among IT patients. Of 319 studies screened, 15 were eventually included in the meta-analysis. The pooled rates of significant liver fibrosis and inflammatory activity for 10 studies were 10% (95% confidence interval [CI] 0.06–0.18) and 16% (95% CI 0.07–0.31), respectively. The pooled mean values of age, alanine aminotransferase level, HBV DNA level, and HBsAg level for another 5 studies with IT patients diagnosed by dual criteria were 30.7 years (95% CI 27.31–34.09), 26.64 IU/mL (95% CI 24.45–28.83), 8.41 log10 cp/mL (95% CI 7.59–9.23), and 4.24 log10 IU/mL (95% CI 3.67–4.82), respectively. Significant histologic changes were not rare events among IT patients. Strictly defined serological diagnostic criteria for the IT phase are warranted. |
| first_indexed | 2024-04-10T22:49:22Z |
| format | Article |
| id | doaj.art-6fe265db8a67478398873522f2c00bd0 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-10T22:49:22Z |
| publishDate | 2023-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-6fe265db8a67478398873522f2c00bd02023-01-15T12:09:27ZengNature PortfolioScientific Reports2045-23222023-01-011311910.1038/s41598-023-27545-zHistologic changes in immune-tolerant patients with chronic hepatitis B: a systematic review and meta-analysisZhiguo Li0Dongliang Yang1Yue Ge2Shu Song3Qin Lv4Yong’an Ye5Department of Gastroenterology, Beijing Fengtai Hospital of Integrated Traditional and Western MedicineDepartment of Math, Cangzhou Medical CollegeDepartment of Gastroenterology, Beijing Fengtai Hospital of Integrated Traditional and Western MedicineDepartment of Gastroenterology, Beijing Fengtai Hospital of Integrated Traditional and Western MedicineDepartment of Gastroenterology, Beijing Fengtai Hospital of Integrated Traditional and Western MedicineInstitute of Liver Diseases, Beijing University of Chinese MedicineAbstract The serological diagnostic criteria for the immune-tolerant (IT) phase have not been strictly defined and it is hard to determine an accurate rate for significant histologic changes among IT patients. The aim of this study was to establish a baseline rate of significant histologic changes and to determine the main characteristics of IT patients. We systematically searched PubMed, Embase, and Web of Science. Studies reporting liver biopsy results (inflammation grade or fibrosis stage) for adults with chronic hepatitis B virus (HBV) infection in the IT phase diagnosed by serological criterion were included to pool the rate of significant histologic changes. Studies that enrolled subjects with confirmed chronic HBV infection in the IT phase diagnosed by serological and liver biopsy criteria (dual criteria) were included to pool the mean values of main characteristics among IT patients. Of 319 studies screened, 15 were eventually included in the meta-analysis. The pooled rates of significant liver fibrosis and inflammatory activity for 10 studies were 10% (95% confidence interval [CI] 0.06–0.18) and 16% (95% CI 0.07–0.31), respectively. The pooled mean values of age, alanine aminotransferase level, HBV DNA level, and HBsAg level for another 5 studies with IT patients diagnosed by dual criteria were 30.7 years (95% CI 27.31–34.09), 26.64 IU/mL (95% CI 24.45–28.83), 8.41 log10 cp/mL (95% CI 7.59–9.23), and 4.24 log10 IU/mL (95% CI 3.67–4.82), respectively. Significant histologic changes were not rare events among IT patients. Strictly defined serological diagnostic criteria for the IT phase are warranted.https://doi.org/10.1038/s41598-023-27545-z |
| spellingShingle | Zhiguo Li Dongliang Yang Yue Ge Shu Song Qin Lv Yong’an Ye Histologic changes in immune-tolerant patients with chronic hepatitis B: a systematic review and meta-analysis Scientific Reports |
| title | Histologic changes in immune-tolerant patients with chronic hepatitis B: a systematic review and meta-analysis |
| title_full | Histologic changes in immune-tolerant patients with chronic hepatitis B: a systematic review and meta-analysis |
| title_fullStr | Histologic changes in immune-tolerant patients with chronic hepatitis B: a systematic review and meta-analysis |
| title_full_unstemmed | Histologic changes in immune-tolerant patients with chronic hepatitis B: a systematic review and meta-analysis |
| title_short | Histologic changes in immune-tolerant patients with chronic hepatitis B: a systematic review and meta-analysis |
| title_sort | histologic changes in immune tolerant patients with chronic hepatitis b a systematic review and meta analysis |
| url | https://doi.org/10.1038/s41598-023-27545-z |
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