Natural history of hepatitis B virus-associated decompensated cirrhosis with low-level viremia: a retrospective study

Abstract

Abstract Background and Aims:Patients with low-level hepatitis B virus (HBV) viremia, HBV DNA negativity, and HBsAg negativity 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.MethodsWe retrospectively reviewed the data of 250 patients with HBV-associated decompensated cirrhosis(HBV DNA＜2000IU/mL) who had not been treated with antiviral medication.ResultsThe 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 LLV. The incidence of hepatocellular carcinoma (HCC) (P < 0.001) and portal vein thrombosis (P = 0.001) was higher in the LLV 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.ConclusionPatients with HBV-associated decompensated cirrhosis still had severe liver damage and could develop severe cirrhosis complications. HCC risk was higher in LLV patients. HBsAg positivity and HBeAg negativity may be associated to the occurrence of LLV.