Antiviral therapy favors a lower risk of liver cirrhosis in HBeAg-negative chronic hepatitis B with normal alanine transaminase and HBV DNA positivity

The research delves into a traditionally overlooked category of CHB patients. While those who are HBeAg-negative with normal ALT levels have been considered low-risk and often excluded from immediate treatment, this study challenges that notion by demonstrating the considerable benefits of ongoing antiviral therapy. Conducted as a retrospective analysis over a median period of 54 months, the study involved 194 patients diagnosed with HBeA-negative CHB. These patients, all with detectable hepatitis B virus (HBV) DNA, were categorized based on their treatment regimes: continuous, intermittent, or no treatment with nucleos(t)ide analogs (NAs).

The findings are groundbreaking. Patients who adhered to continuous NA therapy exhibited a 100% virological response, significantly reducing the risk of developing liver nodules and cirrhosis. This is particularly notable in patients with HBV DNA levels ≥2000 IU/mL, where continuous treatment decreased the risks of liver cirrhosis by 92% compared to those who discontinued or did not receive treatment.

The study suggests that early antiviral treatment can prevent liver disease progression in HBeAg-negative chronic hepatitis B patients with normal ALT and positive HBV DNA, even in the absence of elevated ALT levels. It advocates for a proactive treatment strategy to prevent the progression of liver diseases in HBeAg-negative CHB patients.

This comprehensive research highlights the importance of early intervention and regular monitoring for this patient population, as well as the need for further research to optimize treatment strategies and improve outcomes for patients with chronic hepatitis B. It might set a new course for clinical practices and management in CHB strategies.