Natural history of decompensated cirrhosis with serum hepatitis B DNA < 2000 IU/mL: a retrospective study

Abstract Background and aims Patients with low HBV DNA levels (< 2000 IU/mL), HBV DNA negative, and HBsAg-negative hepatitis B virus(HBV)infection can still progress to decompensated cirrhosis; however, clinical research data in such patients, especially treatment-naïve patients, are currently in...

Full description

Bibliographic Details
Main Authors: Xu Huang, Meimei Yan, Zerun Deng, Lei Yao, Dan Han, Lihua Sun
Format: Article
Language:English
Published: BMC 2022-11-01
Series:BMC Gastroenterology
Subjects:
Online Access:https://doi.org/10.1186/s12876-022-02541-1
_version_ 1798018384404676608
author Xu Huang
Meimei Yan
Zerun Deng
Lei Yao
Dan Han
Lihua Sun
author_facet Xu Huang
Meimei Yan
Zerun Deng
Lei Yao
Dan Han
Lihua Sun
author_sort Xu Huang
collection DOAJ
description Abstract Background and aims Patients with low HBV DNA levels (< 2000 IU/mL), HBV DNA negative, and HBsAg-negative hepatitis B virus(HBV)infection can still progress to decompensated cirrhosis; however, clinical research data in such patients, especially treatment-naïve patients, are currently insufficient. This study assessed the natural history of aforementioned patients. Methods We retrospectively reviewed the data of 250 patients with HBV-associated decompensated cirrhosis(HBV DNA < 2000 IU/mL) who had not been treated with antiviral medication. Results The mean age of the 250 patients was 53.90 ± 11.73 years and 183 patients (73.2%) were male. HBV DNA, HBsAg, and HBeAg positivity was detected in 77 (30.8%), 200 (80%), and 137 (54.8%) patients, respectively. HBsAg (odds ratio [OR], 3.303; 95% confidence interval [CI], 1.338–8.152; P = 0.010) and HBeAg (OR, 0.200; 95% CI, 0.107–0.376; P < 0.001) positivity were independent factors for low HBV DNA levels. The incidence of hepatocellular carcinoma (HCC) (P < 0.001) and portal vein thrombosis (P = 0.001) was higher in the low HBV DNA levels group. Multivariate analysis showed that HBV DNA positivity (OR, 3.548; 95% CI, 1.463–8.604; P = 0.005), HBeAg positivity (OR, 0.080; 95% CI, 0.022–0.289; P < 0.001), and glutamyltransferase (GGT) (OR, 1.003; 95% CI, 1.000–1.006; P = 0.040) were independent factors for HCC. Age was not related to the occurrence of cirrhosis complications. Conclusion Patients with decompensated cirrhosis with HBV DNA < 2000 IU/mL still had severe liver damage and could develop severe cirrhosis complications. HCC risk was higher in low HBV DNA levels patients. HBsAg positivity and HBeAg negativity may be associated to the occurrence of low HBV DNA levels.
first_indexed 2024-04-11T16:23:03Z
format Article
id doaj.art-3e280ffe1a2b4755bcb33a724bfad797
institution Directory Open Access Journal
issn 1471-230X
language English
last_indexed 2024-04-11T16:23:03Z
publishDate 2022-11-01
publisher BMC
record_format Article
series BMC Gastroenterology
spelling doaj.art-3e280ffe1a2b4755bcb33a724bfad7972022-12-22T04:14:16ZengBMCBMC Gastroenterology1471-230X2022-11-012211810.1186/s12876-022-02541-1Natural history of decompensated cirrhosis with serum hepatitis B DNA < 2000 IU/mL: a retrospective studyXu Huang0Meimei Yan1Zerun Deng2Lei Yao3Dan Han4Lihua Sun5Department of Epidemiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan HospitalInfectious Diseases Center, The First Affiliated Hospital of Xinjiang Medical UniversityInfectious Diseases Center, The First Affiliated Hospital of Xinjiang Medical UniversityInfectious Diseases Center, The First Affiliated Hospital of Xinjiang Medical UniversityInfectious Diseases Center, The First Affiliated Hospital of Xinjiang Medical UniversityInfectious Diseases Center, The First Affiliated Hospital of Xinjiang Medical UniversityAbstract Background and aims Patients with low HBV DNA levels (< 2000 IU/mL), HBV DNA negative, and HBsAg-negative hepatitis B virus(HBV)infection can still progress to decompensated cirrhosis; however, clinical research data in such patients, especially treatment-naïve patients, are currently insufficient. This study assessed the natural history of aforementioned patients. Methods We retrospectively reviewed the data of 250 patients with HBV-associated decompensated cirrhosis(HBV DNA < 2000 IU/mL) who had not been treated with antiviral medication. Results The mean age of the 250 patients was 53.90 ± 11.73 years and 183 patients (73.2%) were male. HBV DNA, HBsAg, and HBeAg positivity was detected in 77 (30.8%), 200 (80%), and 137 (54.8%) patients, respectively. HBsAg (odds ratio [OR], 3.303; 95% confidence interval [CI], 1.338–8.152; P = 0.010) and HBeAg (OR, 0.200; 95% CI, 0.107–0.376; P < 0.001) positivity were independent factors for low HBV DNA levels. The incidence of hepatocellular carcinoma (HCC) (P < 0.001) and portal vein thrombosis (P = 0.001) was higher in the low HBV DNA levels group. Multivariate analysis showed that HBV DNA positivity (OR, 3.548; 95% CI, 1.463–8.604; P = 0.005), HBeAg positivity (OR, 0.080; 95% CI, 0.022–0.289; P < 0.001), and glutamyltransferase (GGT) (OR, 1.003; 95% CI, 1.000–1.006; P = 0.040) were independent factors for HCC. Age was not related to the occurrence of cirrhosis complications. Conclusion Patients with decompensated cirrhosis with HBV DNA < 2000 IU/mL still had severe liver damage and could develop severe cirrhosis complications. HCC risk was higher in low HBV DNA levels patients. HBsAg positivity and HBeAg negativity may be associated to the occurrence of low HBV DNA levels.https://doi.org/10.1186/s12876-022-02541-1Low HBV DNA levelsHepatitis B virusDecompensated cirrhosisRetrospective study
spellingShingle Xu Huang
Meimei Yan
Zerun Deng
Lei Yao
Dan Han
Lihua Sun
Natural history of decompensated cirrhosis with serum hepatitis B DNA < 2000 IU/mL: a retrospective study
BMC Gastroenterology
Low HBV DNA levels
Hepatitis B virus
Decompensated cirrhosis
Retrospective study
title Natural history of decompensated cirrhosis with serum hepatitis B DNA < 2000 IU/mL: a retrospective study
title_full Natural history of decompensated cirrhosis with serum hepatitis B DNA < 2000 IU/mL: a retrospective study
title_fullStr Natural history of decompensated cirrhosis with serum hepatitis B DNA < 2000 IU/mL: a retrospective study
title_full_unstemmed Natural history of decompensated cirrhosis with serum hepatitis B DNA < 2000 IU/mL: a retrospective study
title_short Natural history of decompensated cirrhosis with serum hepatitis B DNA < 2000 IU/mL: a retrospective study
title_sort natural history of decompensated cirrhosis with serum hepatitis b dna 2000 iu ml a retrospective study
topic Low HBV DNA levels
Hepatitis B virus
Decompensated cirrhosis
Retrospective study
url https://doi.org/10.1186/s12876-022-02541-1
work_keys_str_mv AT xuhuang naturalhistoryofdecompensatedcirrhosiswithserumhepatitisbdna2000iumlaretrospectivestudy
AT meimeiyan naturalhistoryofdecompensatedcirrhosiswithserumhepatitisbdna2000iumlaretrospectivestudy
AT zerundeng naturalhistoryofdecompensatedcirrhosiswithserumhepatitisbdna2000iumlaretrospectivestudy
AT leiyao naturalhistoryofdecompensatedcirrhosiswithserumhepatitisbdna2000iumlaretrospectivestudy
AT danhan naturalhistoryofdecompensatedcirrhosiswithserumhepatitisbdna2000iumlaretrospectivestudy
AT lihuasun naturalhistoryofdecompensatedcirrhosiswithserumhepatitisbdna2000iumlaretrospectivestudy