[New progress on diagnosis and treatment for indeterminate-phase chronic hepatitis B virus-infected patients]

Area of Science:

• Hepatology
• Virology
• Internal Medicine

Background:

• Chronic hepatitis B virus (HBV) infection is typically classified into four stages by authoritative guidelines.
• A significant proportion (30%-50%) of patients fall into an
• indeterminate phase
• lacking clear classification.
• These patients often exhibit substantial liver damage, including cirrhosis, and are at elevated risk for hepatocellular carcinoma (HCC) and mortality without antiviral treatment.

Purpose of the Study:

• To review current research on the prevalence, clinical characteristics, disease progression, and treatment benefits in indeterminate phase chronic HBV patients.
• To explore strategies for improved management of this patient group.
• To address the lack of unified classification standards and rapid diagnostic methods for at-risk indeterminate phase patients.

Main Methods:

• Literature review of studies on indeterminate phase chronic HBV infection.
• Analysis of clinical characteristics, disease progression, and treatment outcomes.
• Examination of existing guidelines and expert opinions, including the 2022 "Expert Opinions on Expanding Antiviral Treatment for Chronic Hepatitis B".

Main Results:

• Preliminary research indicates that antiviral treatment in indeterminate phase patients yields good virological response and significantly reduces HCC risk.
• Aggressive treatment is recommended for indeterminate phase patients with over one year of follow-up, according to 2022 expert opinions.
• Despite treatment benefits, challenges remain in refining classification and developing non-invasive diagnostic tools for risk stratification.

Conclusions:

• The indeterminate phase of chronic HBV infection represents a critical clinical challenge with significant risks of liver disease progression and HCC.
• Antiviral therapy shows promise for improving outcomes in this population.
• Further research is needed to establish standardized classification criteria and develop effective non-invasive diagnostic methods for better patient management.