A cohort study on factors influencing liver fibrosis progression in chronic HBV-infected patients
- Author:
WANG Baoyu
;
LI Yijun
;
YUAN Xiaojie
- Publication Type:Journal Article
- From:
China Tropical Medicine
2025;25(3):270-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To monitor the dynamic changes in liver stiffness and their correlation with clinical indicators among chronic hepatitis B virus (HBV) infected individuals in Wuwei City, Gansu Province, and to provide important evidence for the early detection and effective intervention of liver fibrosis (LF) progression. Methods Based on the Wuwei Hepatitis B Specialty Cohort, this study conducted annual serological and FibroScan ultrasonographic examinations for 3 882 chronic HBV-infected individuals. Over an average of 4 years of follow-up, the liver fibrosis outcome was monitored, and influencing factors were analyzed by constructing a logistic regression model. Results Among the 2 053 chronic HBV-infected individuals who completed at least one follow-up, baseline LF grades F0 to F4 were distributed as follows: 1 581 cases (77.0%), 164 cases (8.0%), 99 cases (4.8%), 110 cases (5.4%), and 99 cases (4.8%), respectively. Significant differences were observed among the five groups in terms of age, gender, smoking, antiviral treatment, liver function indicators, control attenuation index (CAP), and liver stiffness measurement (LSM) (P<0.05). After an average of 4 years of follow-up, 1 686 cases (17.9/100 person-years) showed no significant change in LF grade, 260 cases (2.8/100 person-years) demonstrated a decrease in LF grade, and 107 cases (1.1/100 person-years) exhibited an increase in LF grade. Stratified by baseline treatment status, among patients with chronic HBV infection who did not undergo treatment, baseline alanine aminotransferase (ALT) (OR=5.50, 95%CI：1.79-16.83, P=0.003) and LSM (OR=3.35, 95%CI：1.23-9.13, P=0.018) were identified as risk factors for LF progression. In contrast, among patients who underwent antiviral treatment, baseline aspartate aminotransferase (AST) (OR=2.23, 95%CI：1.41-3.53, P<0.001) and total bilirubin (TBIL) (OR=1.79, 95%CI：1.14-2.81, P=0.012) levels were identified as risk factors for LF progression. Conclusion LSM and liver function indicators, such as ALT, AST, and TBIL, are important influencing factors for LF progression. The monitoring of LSM and liver function indicators will be of great significance for the prevention and early diagnosis of liver cirrhosis.
- Full text:20251117151634802383.A cohort study on factors influencing liver fibrosis progression in chronic HBV-infected patients.pdf
