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Abstract：
BACKGROUND: This study aimed to investigate the role of immunocompetence in chronic hepatitis B (CHB) patients with normal alanine transaminase (ALT) levels and negative hepatitis B e antigen (HBeAg) in the risk assessments of the progression of liver fibrosis.
METHODS: We collected the clinical data of 57 patients with CHB, with normal ALT levels and negative HBeAg from December 2020 to December 2022. With hepatitis B virus (HBV) DNA > 20 IU/mL and ALT ≤ 40 U/L, these patients had never undergone antiviral therapy. The levels of CD4+ , CD4+ CD25+ , CD8+ , and CD4+ CD25+ CD127LOW regulatory T cells (Tregs) in the patients were detected using flow cytometry; the liver stiffness measurement (LSM) values of the patients were detected using Fibroscan.
RESULTS: There was a statistically significant difference between the levels of fibrosis-4 (FIB-4) and hepatitis B surface antigen (HBsAg) when the cutoff point was HBsAg ≥ 1500 (p < .001). FIB-4 was negatively correlated with HBsAg (R = -0.291, p = .028) and positively correlated with age (R = 0.787, p < .001). LSM was negatively correlated with Treg but this correlation was not statistically significant (p > .05). Findings based on the analysis using logistic regression were as follows: (i) age was the independent risk factor when FIB-4 was used as the indicator for assessing liver fibrosis; (ii) Treg was the independent risk factor when LSM was used as the indicator for assessing liver fibrosis. When Treg was used to predict liver fibrosis, the cutoff value, diagnostic efficacy, area under the receiver operating characteristic (ROC) curve, and p value of the ROC curve were 6.875, 0.641, 0.84, and .027, respectively.
CONCLUSIONS: Age and Treg are independent risk factors for progressive liver fibrosis. The cutoff value of Treg > 6.81 indicates the need for timely antiviral treatment and can serve as an indicator for evaluating liver fibrosis.
METHODS: We collected the clinical data of 57 patients with CHB, with normal ALT levels and negative HBeAg from December 2020 to December 2022. With hepatitis B virus (HBV) DNA > 20 IU/mL and ALT ≤ 40 U/L, these patients had never undergone antiviral therapy. The levels of CD4+ , CD4+ CD25+ , CD8+ , and CD4+ CD25+ CD127LOW regulatory T cells (Tregs) in the patients were detected using flow cytometry; the liver stiffness measurement (LSM) values of the patients were detected using Fibroscan.
RESULTS: There was a statistically significant difference between the levels of fibrosis-4 (FIB-4) and hepatitis B surface antigen (HBsAg) when the cutoff point was HBsAg ≥ 1500 (p < .001). FIB-4 was negatively correlated with HBsAg (R = -0.291, p = .028) and positively correlated with age (R = 0.787, p < .001). LSM was negatively correlated with Treg but this correlation was not statistically significant (p > .05). Findings based on the analysis using logistic regression were as follows: (i) age was the independent risk factor when FIB-4 was used as the indicator for assessing liver fibrosis; (ii) Treg was the independent risk factor when LSM was used as the indicator for assessing liver fibrosis. When Treg was used to predict liver fibrosis, the cutoff value, diagnostic efficacy, area under the receiver operating characteristic (ROC) curve, and p value of the ROC curve were 6.875, 0.641, 0.84, and .027, respectively.
CONCLUSIONS: Age and Treg are independent risk factors for progressive liver fibrosis. The cutoff value of Treg > 6.81 indicates the need for timely antiviral treatment and can serve as an indicator for evaluating liver fibrosis.
摘要：
背景：本研究旨在探讨在正常丙氨酸转氨酶（ALT）水平和乙型肝炎e抗原（HBeAg）阴性的慢性乙型肝炎（CHB）患者的免疫能力在肝纤维化进展的风险评估中的作用。
方法：我们收集了57例CHB患者的临床资料，从2020年12月至2022年12月，ALT水平正常，HBeAg阴性。乙型肝炎病毒（HBV）DNA>20IU/mL和ALT≤40U/L，这些患者从未接受过抗病毒治疗.CD4+的水平，CD4+CD25+,CD8+,使用流式细胞术检测患者的CD4+CD25+CD127LOW调节性T细胞（Tregs）；使用Fibroscan检测患者的肝硬度测量（LSM）值。
结果：当截止点为HBsAg≥1500（p<.001）时，纤维化-4（FIB-4）和乙型肝炎表面抗原（HBsAg）水平之间存在统计学上的显着差异。FIB-4与HBsAg呈负相关（R=-0.291，p=0.028），与年龄呈正相关（R=0.787，p<.001）。LSM与Treg呈负相关,但无统计学意义(p>.05)。基于使用logistic回归分析的结果如下：（i）当FIB-4用作评估肝纤维化的指标时，年龄是独立的危险因素；（ii）当LSM用作评估肝纤维化的指标时，Treg是独立的危险因素。当Treg用于预测肝纤维化时，截止值，诊断效能,接收器工作特性(ROC)曲线下面积，ROC曲线的p值分别为6.875、0.641、0.84和0.027。
结论：年龄和Treg是进行性肝纤维化的独立危险因素。Treg>6.81的截断值表明需要及时抗病毒治疗，可以作为评价肝纤维化的指标。
方法：我们收集了57例CHB患者的临床资料，从2020年12月至2022年12月，ALT水平正常，HBeAg阴性。乙型肝炎病毒（HBV）DNA>20IU/mL和ALT≤40U/L，这些患者从未接受过抗病毒治疗.CD4+的水平，CD4+CD25+,CD8+,使用流式细胞术检测患者的CD4+CD25+CD127LOW调节性T细胞（Tregs）；使用Fibroscan检测患者的肝硬度测量（LSM）值。
结果：当截止点为HBsAg≥1500（p<.001）时，纤维化-4（FIB-4）和乙型肝炎表面抗原（HBsAg）水平之间存在统计学上的显着差异。FIB-4与HBsAg呈负相关（R=-0.291，p=0.028），与年龄呈正相关（R=0.787，p<.001）。LSM与Treg呈负相关,但无统计学意义(p>.05)。基于使用logistic回归分析的结果如下：（i）当FIB-4用作评估肝纤维化的指标时，年龄是独立的危险因素；（ii）当LSM用作评估肝纤维化的指标时，Treg是独立的危险因素。当Treg用于预测肝纤维化时，截止值，诊断效能,接收器工作特性(ROC)曲线下面积，ROC曲线的p值分别为6.875、0.641、0.84和0.027。
结论：年龄和Treg是进行性肝纤维化的独立危险因素。Treg>6.81的截断值表明需要及时抗病毒治疗，可以作为评价肝纤维化的指标。
