The impact of past hepatitis B virus infection on biochemical response and prognosis of patients with autoimmune hepatitis

Abstract

Abstract: Objective To explore the impact of past infection of hepatitis B virus (HBV) on the biochemical response and prognosis of patients with autoimmune hepatitis (AIH).Methods Patients diagnosed with AIH from January 2002 to December 2020 at liver research center, Beijing Friendship Hospital, Capital Medical University were included. The clinical characteristics, biochemical response and end-point events such as hepatocellular carcinoma, liver transplantation and death from liver diseases were compared between the AIH patients with and without past HBV infection.Results 114 AIH patients with sufficient baseline and follow-up clinical data were retrieved, of which 74 patients were without past HBV infection and the rest of 40 patients were with HBV infection. The baseline levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were significantly lower in AIH patients with past HBV infection (99.5 vs.178.0, P=0.046; 137.2 vs.161.0, P=0.049, respectively). When compared with AIH patients without past HBV infection, patients with past HBV infection showed higher positivity of antineutrophil cytoplasmic antibody (ANCA) (35.7% vs. 4.8%, P=0.028). No significant difference was shown in the biochemical responsive rate and the incidence of end-point events between these two groups. Past HBV infection was not associated with biochemical response (OR=1.06, 95%CI: 0.03-1.21, P=0.106) and end-point events (HR=1.68, 95%CI: 0.42-6.75, P=0.463). However, the level of globulin (OR=1.06, 95%CI: 1.02-1.11, P=0.030) and the normalization of IgG (OR=3.75, 95%CI: 1.22-11.49, P=0.021) at 3 months of immunosuppressive therapy were independent predictors of complete biochemical response of the AIH patients at 1 year of the treatment. Liver stiffness (HR=1.06, 95%CI: 1.00-1.12, P=0.045) and decompensated cirrhosis (HR=7.54, 95%CI: 1.27-44.72, P=0.026) were risk factors of poor prognosis.Conclusion Compared with AIH patients without past HBV infection, AIH patients with past HBV infection can achieve comparable biochemical response and prognosis once immunosuppressive therapy has been initiated.

Key words: Autoimmune hepatitis, Past hepatitis B viral infection, Biochemical response, Prognosis

SU Yu, SUN Xiao-yi, WANG Qian-yi, ZHAO Xin-yan, JIA Ji-dong. The impact of past hepatitis B virus infection on biochemical response and prognosis of patients with autoimmune hepatitis[J]. Chinese Hepatolgy, 2022, 27(7): 789-794.

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