Study participants
This study was nested in a real-life prospective observational CHB
cohort (Search-B cohort: NCT02167503). The study design and inclusion
criteria for the Search-B cohort have been previously
described.26 Patients with CHB who achieved
undetectable HBV DNA levels for at least 12 months after antiviral
treatment at Nanfang Hospital between September 2015 and July 2017 were
enrolled in this study. Patients meeting any of the following exclusion
criteria were excluded: (1) coinfection with hepatitis C virus and
hepatitis D virus; (2) diagnosis of malignant tumor; (3) excessive
alcohol consumption (>21 units of alcohol per week for men
and >14 units of alcohol per week for women) in the
previous six months; (4) receiving medications with known effects on
ALT, such as Chinese traditional medicines, anti-tuberculosis drugs,
lipid-lowering drugs, nonsteroidal anti-inflammatory drugs, and
antibiotics; (5) diagnosis of systemic inflammatory diseases, diabetes,
and autoimmune liver disease; (6) HBV DNA ≥ 20 IU/mL during follow-up;
and (6) loss of follow-up.
Written informed consent for clinical data and blood sample collection
was obtained from each patient during recruitment. The study protocol
was approved by the Ethics Committee of Nanfang Hospital (Guangzhou,
China).