Indexing
CÁC SỐ TỪ 2011-2023
Tạp chí Y Dược Học
Abstract
Background: Chronic hepatitis B (CHB) is a major public health challenge in Vietnam. Many patients have normal alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, yet clinically relevant fibrosis may progress silently. This study assessed fibrosis prevalence using transient elastography (FibroScan®) and identified factors associated with significant fibrosis (≥ F2) in CHB patients with normal aminotransferases.
Methods: We conducted a cross-sectional study among CHB patients aged ≥ 18 years at the Gastroenterology Clinic of 115 People’s Hospital, Ho Chi Minh City, from April 2024 to March 2025. Eligible patients were treatment-naïve with normal ALT and AST (Vietnam Ministry of Health 2019 definition). Clinical, laboratory, and virological data were collected, and liver stiffness was measured by transient elastography. Logistic regression was used to assess predictors of fibrosis.
Results: Among 220 patients, 86.4% had no or mild fibrosis (F0 - F1), 12.3% had significant fibrosis (F2), and 1.3% had advanced fibrosis (F3); none had cirrhosis (F4). In multivariable analysis, older age (OR 1.06; 95% CI 1.02 - 1.11) and lower platelet count (OR 0.98; 95% CI 0.98 - 0.99) were independent predictors of significant fibrosis. According to the 2019 Vietnam Ministry of Health guidelines, 23.2% of patients with normal aminotransferases met indications for antiviral therapy, whereas application of the 2024 WHO criteria increased eligibility to 34.1%.
Conclusions: A substantial proportion of CHB patients with normal aminotransferases had significant fibrosis, underscoring the limitations of ALT-based monitoring. Incorporating non-invasive fibrosis assessment into HBV programs could support earlier treatment and accelerate elimination efforts.
| Published | 2026-08-25 | |
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| Issue | Vol. 16 No. 04 (2026) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2026.4.723 | |
| Keywords | Keywords: Chronic hepatitis B, liver fibrosis, transient elastography, FibroScan®, aminotransferases, Vietnam |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2026 Hue Journal of Medicine and Pharmacy
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