The Incidence and the Clinical Significance of the Gray Zone in the Clinical Phases of Chronic Hepatitis B Virus Infection

Background: five clinical phases were described in patients with chronic (HBV) infection: HBeAg- positive HBV infection, CHB, HBeAg negative HBeAg-negative CHB and occult infection.
 Aim: This study aimed to determine the incidence of unclassified phase (gray zone) hepatitis B its significant practice. 
 Patients methods: The was conducted retrospectively on 109 patients' who have HBsAg for more than 6 months. data recorded include; HbeAg anti-HBe Ab, ultrasound abdomen, DNA load alanine aminotransferase (ALT), accordingly; we classify known phases. unfit one these considered be gray zone subsequently sent liver fibroscan fibrosis stage. Results: mean age our 34.25 (±13.9) years 54.12% being males. viral 5,885,490 IU/ml ALT 56.22 (±89.88) U/L. eight (7.3%) HBeAg+ve 13 (11.9%) . Thirty four (31.1%) HBeAg-ve infection 23 (21.1%) phase, both showed a statistical relationship age> 35 years. (28.4%) further failed identify any (normal > 2000 IU/ml), this group also relation above 12 (38.8%) had fibroscan.
 Conclusions: A considerable number persistently normal levels, despite elevated levels load; is as "grey zone" phase. These merit close follow up short-interval measurement enzymes, biopsy may considered.