Increased Risk for Liver Disease in Patients With Chronic Hepatitis B Virus Infection and Low‐Level Viraemia

作者：Paul Y. Kwo, Laura Telep, LV Hong, Ching Yi Chuo, Betty Chiang, S Naik, Catherine Frenette, A. Singer, Anand P. Chokkalingam, Robert J. Wong, Leland J. Yee, Camilla S. Graham · 发表于：Alimentary Pharmacology & Therapeutics · 年份：2026 · DOI：10.1111/apt.70613 · 被引用次数：2 · 研究领域：Hepatitis B Virus Studies、Hepatitis C virus research、Hepatitis Viruses Studies and Epidemiology

BACKGROUND: The relationship between hepatitis B virus low-level viraemia (HBV-LLV; HBV DNA ≤ 2000 IU/mL) and the risk of liver-related events is unclear. AIM: To evaluate the relationship between HBV-LLV and subsequent liver-related outcomes in patients with chronic HBV. METHODS: Using Optum's deidentified Clinformatics Data Mart Database, propensity score-matched cohorts of adults (aged ≥ 18 years) with chronic HBV-LLV vs. controls without evidence of chronic HBV were identified. Cox proportional-hazards models were used to estimate the risk of compensated cirrhosis, hepatic decompensation, hepatocellular carcinoma (HCC), liver transplant, and a composite outcome of these four liver-related events among people with HBV-LLV vs. those without HBV. Incidence rates per 100 person-years and corresponding Poisson 95% CIs were calculated for each cohort. RESULTS: Demographic and clinical characteristics were similar between cohorts. The risk of cirrhosis, decompensation, HCC, and the composite outcome was significantly higher for patients with HBV-LLV than for individuals without HBV. Elevated liver disease risk remained in a sensitivity analysis of a subgroup with no nucleos(t)ide analogue treatment or HBV DNA > 2000 IU/mL during follow-up. Elevated risk of cirrhosis and composite outcomes in patients with HBV-LLV was confirmed in a second US dataset (HealthVerity Marketplace). CONCLUSIONS: In this analysis of US administrative claims data, individuals with HBV-LLV had a signific...