Modification of clinical indicators for differentiating stages of chronic HBV infection based on pathological changes in liver tissue

Objective To screen and modify more accurate clinical and viral indicators for differentiating the different stages of chronic hepatitis B virus (HBV) infection based on liver histopathological changes. Methods The clinical and liver pathology data of chronic hepatitis B (CHB) patients undergoing liver biopsy were collected for retrospective analysis. The area under the curve (AUC) of the receiver operating characteristic (ROC) was used to evaluate the diagnostic value for differentiating the different stages of chronic HBV infection. Results A total of 118 patients who met the diagnostic and exclusion criteria were selected. There were significant differences among HBV DNA, hepatitis B surface antigen (HBsAg), HBeAg, HBcAb, and platelets (PLT) between the IT and IC stages. Platelets were significantly higher in patients with the IT stage of CHB than in patients with the IC stage, whereas HBcAb levels were directly reversed. Multivariate analysis showed that HBeAg independently correlated with the IT and IC stages. Univariate analysis showed that HBV DNA and HBsAg were quantified between the ICO and IR stages except for ALT. The cutoff value of HBeAg used to quantitatively differentiate between IT and IC was 1335 and the AUC was 0.921 (95% confidence interval (CI): 0.836 to 0.971). Conclusions The high levels of HBeAg rather than HBeAg positive might help to identify patients with the “true” IT stage. PLT and HBcAb are effective indicators for differentiating patients between the IT and IC stages of chronic HBV infection. HBV DNA of <20 IU/mL may be a more rational cutoff value for ICO patients. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee of Taizhou Hospital of Zhejiang Province gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present work are contained in the manuscript.