Analysis of influencing factors and predictive efficacy of recompensation in patients with decompensated hepatitis B cirrhosis
ZHU Ningning
JIAO Shuning
ZHANG Yushuang
GAO Lin
LI Tao
WANG Yan
LIN Chunlei
Abstract：Objective To analyze the influencing factors of recompensation in patients with decompensated hepatitis B cirrhosis and to evaluate their predictive efficacy.Methods Totally 183 patients with hepatitis B cirrhosis who were subjected to first-line nucleos(t)ide analogue therapy(for at least 12 months)due to initial decompensation were enrolled.According to the Baveno VII criteria,they were divided into the recompensation group(n=106)and persistent decompen-sation group(n=77).Demographic data(sex and age)and laboratory parameters[white blood cell count,hemoglobin,platelet count,aspartate aminotransferase(AST),alanine aminotransferase(ALT),γ-glutamyl transpeptidase,total bili-rubin,albumin,creatinine,serum sodium,alpha-fetoprotein,international normalized ratio,HBeAg,and serum HBV DNA]were collected,the synthesis of diabetes mellitus was recorded and the model for end-stage liver disease(MELD)score and AST/ALT ratio were calculated.Univariate and multivariate Logistic regression analyses were performed to iden-tify the influencing factors of recompensation in patients with decompensated hepatitis B cirrhosis.The predictive efficacy was evaluated using receiver operating characteristic(ROC)curve.Results Compared with the persistent decompensa-tion group,the recompensation group was younger,and had a lower proportion of males,lower AST/ALT ratio,and higher serum HBV DNA levels(all P<0.05).Logistic regression analysis revealed that sex,age,AST/ALT ratio,and serum HBV DNA levels were independent influencing factors for recompensation in patients with decompensated hepatitis B cir-rhosis(all P<0.05).Subgroup analysis demonstrated consistent associations between these independent factors and recom-pensation across different subgroups(all P>0.05).ROC curve analysis showed that the area under the curve(AUC)of AST/ALT ratio,age,and serum HBV DNA levels in predicting recompensation was 0.735,with a sensitivity of 0.61,and a specificity of 0.77.Conclusions Sex,age,AST/ALT ratio,and serum HBV DNA levels are independent influ-encing factors for recompensation in patients with decompensated hepatitis B cirrhosis.Patients who are female,younger(≤53 years old),have a lower AST/ALT ratio(≤0.983),and higher HBV DNA level(>0.502 log10 IU/mL)are more likely to achieve recompensation.
Keywords：cirrhosishepatitis B virushepatitis Bdecompensated cirrhosisrecompensationAST/ALTHBV DNA
Publication Date：2025-06-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 67-72 )