Very low probability of significant liver inflammation in chronic hepatitis B patients with low ALT levels in the absence of liver fibrosis.
Milan J SonneveldWillem Pieter BrouwerBettina E HansenHenry Lik Yuen ChanTeerha PiratvisuthJi-Dong JiaStefan ZeuzemRong-Nan ChienHannah ChoiRobert J de KnegtCynthia WatVedran PavlovicAnuj GaggarQing XieMaria Buti FerretRobert A de ManHarry L A Janssennull nullPublished in: Alimentary pharmacology & therapeutics (2020)
Among patients without significant fibrosis, an ALT level < 2 times ULN is associated with < 5% probability of significant inflammatory activity. If fibrosis can be ruled out using non-invasive methods, liver biopsy solely to assess inflammatory activity should be discouraged.