ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1549791
48-week prognostic analysis of patients with very low-level viremia in hepatitis B cirrhosis: A single-center retrospective study
Provisionally accepted
- Taiyuan Third People's Hospital, Taiyuan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: With the improvement of the accuracy of HBV DNA detection, some patients with chronic hepatitis B (CHB) still have very low-level viremia (VLLV, HBV DNA is detectable but less than 20 IU/mL) after achieving a complete virologic response (CVR). This study aimed to investigate the prognosis of cirrhotic hepatitis B patients with VLLV. Methods: 267 treated patients with hepatitis B cirrhosis were retrospectively enrolled from the Third People's Hospital of Taiyuan. All of them took oral antiviral drugs for more than 96 weeks, and they were divided into the target not detected group (TND, HBV DNA undetectable) and the VLLV group (limits of detection< HBV DNA < 20 IU/ml) by high-sensitivity testing of HBV. The incidence of cirrhosis-related complications was mainly observed. Results: Compared to the TND group, the baseline levels of ALT (20.0 vs. 26.0 U/L, p<0.001), AST (24.0 vs. 27.5 U/L, p<0.001), and GGT (21.0 vs. 30.5 U/L, p=0.001) were significantly higher in the VLLV group, and so were liver stiffness values (9.4 vs. 10.8 kPa, p=0.006). No significant difference was observed in the rate of new cirrhosis-related complications between the two groups. The rate of HCC was 5.4% in the TND and 4.7% in the VLLV (p>0.05). Multifactorial logistic regression showed that the main factors affecting complications at baseline were age (OR:1.063, p=0.034), hemoglobin (OR:0.965, p=0.036), and platelet (OR:0.987, p=0.029). Conclusions: For cirrhotic patients with VLLV, the lower the level of HBV DNA, the less severe the liver injury. They had no difference in 48-week complication rates from the TND group. Even in the TND group, who can still develop new complications, regular follow-up should be performed necessarily.
Keywords: Chronic hepatitis B, cirrhosis, Hepatocellular Carcinoma, high sensitivity of HBV DNA detection, very low-level viremia
Received: 22 Dec 2024; Accepted: 18 Jun 2025.
Copyright: © 2025 Feng, Wang, Shi, Zhou, Hua, Wang and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yinong Feng, Taiyuan Third People's Hospital, Taiyuan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.