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

作者：Rui Huang, Ai‐Thien Do, Hidenori Toyoda, Jie Li, Satoshi Yasuda, Pei‐Chien Tsai, Ming‐Lun Yeh, Huy N. Trinh, Angela Chau, Daniel Q. Huang, Eiichi Ogawa, Takanori Ito, Ritsuzo Kozuka, Masanori Atsukawa, Sebastián Marciano, Takashi Honda, Tsunamasa Watanabe, Norio Itokawa, Carmen Monica Preda, Cheng‐Hao Tseng, Ana Barreira‐Díaz, Kaori Inoue, Hirokazu Takahashi, Haruki Uojima, Keigo Kawashima, Yao‐Chun Hsu, Raluca Ioana Marin, Irina Sandra, Masatoshi Ishigami, Jiayi Li, Jian Zhang, Do Ngoc Son, Mayumi Maeda, Dong‐Hyun Lee, Wan‐Long Chuang, Chia‐Yen Dai, Jee‐Fu Huang, Chung‐Feng Huang, Ramsey Cheung, Marı́a Buti, Yasuhito Tanaka, Man‐Fung Yuen, Masaru Enomoto, Adrián Gadano, Seng Gee Lim, Ming‐Lung Yu, Chao Wu, Mindie H. Nguyen · 发表于：Alimentary Pharmacology & Therapeutics · 年份：2025 · DOI：10.1111/apt.70194 · 被引用次数：5 · 研究领域：Hepatitis B Virus Studies、Hepatitis C virus research、Hepatitis Viruses Studies and Epidemiology

BACKGROUND AND AIMS: Chronic hepatitis B (CHB) with indeterminate phase comprises a heterogeneous group of patients. We determined the prevalence of indeterminate CHB overall and characterised novel types and phase transition probabilities of novel types of indeterminate CHB. METHODS: CHB patients were enrolled retrospectively from 24 centres (9 countries/regions). Indeterminate phase was defined based on the AASLD 2018 guidance. RESULTS: IU/mL, respectively. Of the total cohort, half (47.2%) were in the indeterminate phase; and of these, the most prevalent group among HBeAg-positive patients was Type 2 (ALT 1-2 × ULN, HBV DNA≥ 20,000 IU/mL; 12.6%), while in HBeAg-negative patients it was Type 6 (ALT<ULN, HBV DNA≥ 2000 IU/mL; 30.1%). Among the 1530 indeterminate patients with long-term follow-up, the 10-year cumulative incidence of phase transition to immune tolerant, immune active and immune inactive phases were 6.5%, 32.1% and 64.3%, respectively. The majority (73.2%) of Type 2 indeterminate patients transitioned to the immune active phase, while only 16.5% of Type 8 (HBeAg-negative, ALT 1-2 × ULN, HBV DNA < 2000 IU/mL) did. CONCLUSIONS: Indeterminate CHB can be classified into 10 types, with the most prevalent type being those with HBeAg-negative, HBV DNA ≥ 2000 IU/mL and ALT<ULN (30.1%). The most prevalent HBeAg-positive patients with ALT 1-2 × ULN and HBV DNA ≥ 20,000 IU/mL type was also the most likely to transition to the immune-active phase (73.2% by year-10). The mon...