RESEARCH ARTICLE Age as a Predictor of Significant Fibrosis Features in HBeAg-Negative Chronic Hepatitis B Virus Infection with Persistently

Background Although alanine aminotransferase (ALT) levels reflect the degree of liver damage, not all patients with chronic hepatitis B virus (HBV) infection exhibit persistently elevated ALT lev-els. In the present study, we aimed to comprehensively evaluate the characteristics of histo-logical abnormalities in a large population of Chinese patients with chronic HBV and persistently normal ALT levels. Methods In total, 2303 consecutive patients who underwent liver biopsy were screened. Of these pa-tients, 273 were categorized as having persistently normal ALT levels (PNALT), whereas 618 were categorized as having persistently or intermittently elevated ALT levels (PIALT). All these patients had at least three ALT values recorded in the year prior to the baseline liver biopsy. Results Significant necroinflammation was observed in 9.7 % (11/113) patients with PNALT, 23.3