Demographic and clinical information of participants
As shown in Figure 1A, 1709 patients with CHB who had undetectable serum
HBV DNA levels for at least 12 months after antiviral treatment were
screened. In total, 208 participants were excluded at baseline, and 263
participants were excluded during follow-up (median follow-up: 2.42
years). Finally, 1238 patients with CHB were included in the analysis.
Among these patients, 510 (41.19%) experienced elevated ALT during
follow-up, 40 (3.23%) showed PeALT at all visits, and only 55.57%
maintained PnALT.
To further investigate the potential reason for elevated ALT, we matched
40 patients with PeALT and 40 with PnALT using propensity score
matching. Confounding factors, including sex, age, body mass index
(BMI), follow-up duration, serum triglyceride (TG) and cholesterol
levels, and CAP, were well-matched between these two groups. Baseline
demographics and clinical information of the patients are summarized in
Table 1. The serum ALT (49.5 [42, 64.5] vs. 21 [14, 25.75)]) and
AST (31 [25.25, 38] vs. 20 [19, 25] levels were significantly
higher in the PeALT group than in the PnALT group. The dynamic changes
in ALT and AST levels are shown in Figure 1B and 1C. In addition to ALT
levels, the serum AST level in patients with PeALT was consistently and
significantly higher than that in patients with PnALT, indicating
sustained liver injury.