Related Experiment Video

Updated: May 22, 2025

Detection of Low Copy Number Integrated Viral DNA Formed by In Vitro Hepatitis B Infection
11:14

Detection of Low Copy Number Integrated Viral DNA Formed by In Vitro Hepatitis B Infection

Published on: November 7, 2018

18.3K

Distribution, Characteristics, and Natural History of Diverse Types of Indeterminate Chronic Hepatitis B: A REAL-B

Rui Huang1,2,3, Ai-Thien Do1,4,5, Hidenori Toyoda6

  • 1Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.

Alimentary Pharmacology & Therapeutics
|May 21, 2025
PubMed

Insights

Half of chronic hepatitis B (CHB) patients are in the indeterminate phase, with distinct types and transition probabilities. Management of indeterminate CHB requires individualized care based on specific patient types.

Area of Science:

  • Hepatology
  • Virology
  • Clinical Medicine

Background:

  • Chronic hepatitis B (CHB) indeterminate phase represents a heterogeneous patient group.
  • Understanding the prevalence and characteristics of indeterminate CHB is crucial for effective management.

Purpose of the Study:

  • To determine the prevalence of indeterminate CHB.
  • To characterize novel types of indeterminate CHB.
  • To assess phase transition probabilities for these novel types.

Main Methods:

  • Retrospective enrollment of 8375 CHB patients from 24 centers across 9 countries.
  • Definition of indeterminate phase based on AASLD 2018 guidance.
  • Analysis of patient demographics, HBeAg status, ALT levels, and HBV DNA levels.

Main Results:

  • 47.2% of the cohort were in the indeterminate phase.
  • Most prevalent HBeAg-positive indeterminate type: Type 2 (12.6%).
  • Most prevalent HBeAg-negative indeterminate type: Type 6 (30.1%).
  • 10-year transition probabilities: 6.5% to immune tolerant, 32.1% to immune active, 64.3% to immune inactive.
  • Type 2 indeterminate patients had a 73.2% transition to immune active phase; Type 8 had 16.5%.

Conclusions:

  • Indeterminate CHB can be classified into 10 types.
  • Type 6 (HBeAg-negative, HBV DNA ≥2000 IU/mL, ALT
  • Type 2 (HBeAg-positive, ALT 1-2xULN, HBV DNA ≥20,000 IU/mL) is most likely to transition to immune-active phase (73.2%).
  • Individualized monitoring and management based on CHB indeterminate type are recommended.
Abstract

Keywords:
HBVgrey zonelongitudinallong‐term follow‐upphase transitionprevalence

More Related Videos

Modeling Hepatitis B Virus Infection in Non-Hepatic 293T-NE-3NRs Cells09:02

Modeling Hepatitis B Virus Infection in Non-Hepatic 293T-NE-3NRs Cells

Published on: June 5, 2020

7.3K
Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection04:11

Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection

Published on: December 15, 2023

3.1K

Related Concept Videos

Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
375
Chronic Pancreatitis I: Introduction01:24

Chronic Pancreatitis I: Introduction

The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
56
Diseases of the Liver and Gallbladder01:26

Diseases of the Liver and Gallbladder

Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
409
Anatomy of the Intestines01:23

Anatomy of the Intestines

Although digestion of proteins, carbohydrates, and lipids may begin in the stomach, it is completed in the intestine. The absorption of nutrients, water, and electrolytes from food and drink also occurs in the intestine. The intestines can be divided into two structurally distinct organs—the small and large intestines.
Small Intestines
The small intestine is an ~7 meter-long tube with an inner diameter of just 2.5 cm. Since most nutrients are absorbed here, the inner lining of the...
71.2K
Retrovirus Life Cycles01:10

Retrovirus Life Cycles

Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the...
45.5K