Zhonghua Yi Xue Za Zhi. 2026 Aug 11;106(29):3026-3032. doi: 10.3760/cma.j.cn112137-20260306-00626.
ABSTRACT
Objective: To analyze the influencing factors associated with cirrhosis in patients with indeterminate-phase chronic hepatitis B (CHB). Methods: CHB patients in the indeterminate phase who did not receive antiviral treatment at the Senior Department of Hepatology, the Fifth Medical Center of Chinese PLA General Hospital between January 2020 and June 2025 were retrospectively included. According to whether cirrhosis had occurred, the patients were divided into the cirrhosis group (patients diagnosed with cirrhosis) and the non-cirrhosis group (patients not diagnosed with cirrhosis). Differences in demographic characteristics, virological indicators, routine blood parameters, and liver function-related clinical indicators were compared between the two groups. Restricted cubic spline analysis was used to determine the threshold values of platelet and age in relation to cirrhosis risk. A multivariate logistic regression model was used to analyze factors associated with cirrhosis in patients with indeterminate-phase CHB. Results: A total of 422 patients was included. There were 182 patients in the cirrhosis group with 128 males and 54 females, aged (47±9) years; and 240 patients in the non-cirrhosis group with 146 males and 94 females, aged (43±11) years. Patients in the cirrhosis group were older than those in the non-cirrhosis group (P<0.001). The distribution of HBV DNA differed statistically between the two groups (P=0.002). Compared with the non-cirrhosis group, the cirrhosis group had a lower proportion of low HBV DNA load (<2×10³ U/ml) [14.8% (27/182) vs 29.6% (71/240), P<0.001] and a higher proportion of intermediate HBV DNA load (2×10³-<2×107 U/ml) [67.6% (123/182) vs 57.5% (138/240), P=0.032], whereas the proportion of high HBV DNA load (≥2×107 U/ml) did not differ significantly [17.6% (32/182) vs 12.9% (31/240), P=0.160]. Platelet count [M (Q1, Q3), 158 (94, 199)×109/L vs 205 (171, 244)×109/L] and HBsAg levels (log HBsAg) [2.9 (2.5, 3.2) vs 3.1 (2.7, 3.6) U/ml] were lower in the cirrhosis group than those in the non-cirrhosis group (both P<0.001). Restricted cubic spline analysis showed non-linear associations of platelet count and age with cirrhosis risk in patients with indeterminate-phase CHB (P<0.05). The corresponding threshold values were 45 years and 180×109/L of age and platelet count, respectively. Multivariate logistic regression analysis showed that decreased HBsAg levels (log HbsAg) (OR=1.99, 95%CI: 1.35-2.93), HBV DNA between 2×10³ and<2×107 U/ml (OR=2.12, 95%CI: 1.18-3.81), HBV DNA≥2×107 U/ml (OR=4.02, 95%CI: 1.80-9.00), age≥45 years (OR=2.06, 95%CI: 1.32-3.24), and platelet count<180×109/L (OR=3.99, 95%CI: 2.55-6.23) were associated with cirrhosis in patients with indeterminate-phase CHB. Conclusion: Age≥45 years, platelet count<180×10⁹/L, HBV DNA≥2×10³ U/ml and decreased HBsAg are influencing factors for the progression to cirrhosis in patients with indeterminate-phase CHB who did not receive antiviral treatment.
PMID:42571969 | DOI:10.3760/cma.j.cn112137-20260306-00626
