Unstable Recompensation: An Intermediate Subtype in Patients With HBV ‐Related Decompensated Cirrhosis

作者：Shuai Xia, Zhiying He, Xiaoning Wu, Zhongjie Hu, Chunqing Zhang, Yanqin Hao, Yongfeng Yang, Yan Huang, Wei Rao, Xiaoqian Xu, Xingyu Zhao, Jialing Zhou, Yameng Sun, Shuyan Chen, Luqi Tang, Xiaojuan Ou, Xinyan Zhao, Jidong Jia, Bingqiong Wang, Hong You · 发表于：Alimentary Pharmacology & Therapeutics · 年份：2025 · DOI：10.1111/apt.70430 · 被引用次数：4 · 研究领域：Hepatitis B Virus Studies、Liver Disease and Transplantation、Health Systems, Economic Evaluations, Quality of Life

BACKGROUND AND AIM: Recent studies show that patients with hepatitis B virus (HBV)-related decompensated cirrhosis who achieve recompensation can still experience further decompensation, suggesting that recompensation status can change over time. This study aimed to classify patterns of recompensation and charaterize the clinical differences among these subgroups. METHODS: Eligible patients with HBV-related decompensated cirrhosis were enrolled from two cohorts. Clinical characteristics and complications were assessed every 6 months for up to 5 years following their first episode of decompensation. Recompensation was defined according to the Baveno VII criteria and further categorised as stable (no subsequent decompensation) or unstable (recurrent decompensation or recompensation following multiple decompensation episodes). RESULTS: A total of 378 patients were included; 294 (77.8%) achieved recompensation, while 84 (22.2%) did not. After a median follow-up of 5.3 years (IQR 4.4-5.8), recompensated patients were classified into stable recompensation (202/378, 53.4%) and unstable recompensation (92/378, 24.3%). The 5 year rate of hepatocellular carcinoma (HCC) or all-cause mortality was higher in the unstable group than the stable group (14.7% vs. 10.1%, p = 0.038), yet remained lower than in patients with ongoing decompensation. Liver function improvement was intermediate in the unstable group compared with the stable recompensation and ongoing decompensation. Logistic regres...