Modification of clinical indicators for differentiating stages of chronic HBV infection based on pathological changes in liver tissue

ObjectiveTo screen and modify more accurate clinical and viral indicators for differentiating the different stages of chronic hepatitis B virus (HBV) infection based on liver histopathological changes. MethodsThe clinical and liver pathology data of chronic hepatitis B (CHB) patients undergoing liver biopsy were collected for retrospective analysis. The area under the curve (AUC) of the receiver operating characteristic (ROC) was used to evaluate the diagnostic value for differentiating the different stages of chronic HBV infection. ResultsA total of 118 patients who met the diagnostic and exclusion criteria were selected. There were significant differences among HBV DNA, hepatitis B surface antigen (HBsAg), HBeAg, HBcAb, and platelets (PLT) between the IT and IC stages. Platelets were significantly higher in patients with the IT stage of CHB than in patients with the IC stage, whereas HBcAb levels were directly reversed. Multivariate analysis showed that HBeAg independently correlated with the IT and IC stages. Univariate analysis showed that HBV DNA and HBsAg were quantified between the ICO and IR stages except for ALT. The cutoff value of HBeAg used to quantitatively differentiate between IT and IC was 1335 and the AUC was 0.921 (95% confidence interval (CI): 0.836 to 0.971). ConclusionsThe high levels of HBeAg rather than HBeAg positive might help to identify patients with the "true" IT stage. PLT and HBcAb are effective indicators for differentiating patients between the IT and IC stages of chronic HBV infection. HBV DNA of <20 IU/mL may be a more rational cutoff value for ICO patients.