Abstract: Objective To explore the clinical characteristics and influencing factors of patients with first-time decompensated hepatitis B-related cirrhosis accompanied by esophageal and gastric fundus variceal rupture and bleeding who have achieved recompensation. Methods A retrospective study was conducted on 69 inpatients with hepatitis B-related cirrhosis in the Second Affiliated Hospital of Baotou Medical College from January 2015 to January 2024. All patients were followed-up with the occurrence of the first recompensation or ≥2 decompensations (continuous decompensation) as the end-point. Based on their outcomes the patients were divided into a recompensation group and a continuous decompensation group. The independent influencing factors of re-compensation were analyzed. The differences in the cumulative occurrences of liver cancer were analyzed among patients with different compensatory states. Results Among the 69 patients with decompensated hepatitis B-related cirrhosis, 32 cases ultimately achieved re-compensation and 37 cases remained decompensation after antiviral treatment. Compared the data of patients in re-compensation group with those of persistent decompensation group, age (HR=0.94, 95%CI: 0.90~0.99, P=0.02), CTP scores (HR=0.63, 95%CI: 0.46~0.86, P<0.05), MELD scores (HR=0.90, 95%CI: 0.85~0.96, P<0.05) were identified to be independent influencing factors of re-compensation; When compared the clinical data of patients at re-compensation with those at first decompensation, there were significant statistical differences in CTP scores [(6.12±1.07) score vs. (7.91±1.59) score, OR=1.79, 95%CI: 1.01~3.16, P=0.05], Alb [(38.80±4.51)g/L vs. (30.98±4.98)g/L, OR=0.82, 95%CI: 0.68~0.97, P=0.02], Hb [(123.28±28.96)g/L vs. (89.69±23.49)g/L, OR=0.96, 95%CI: 0.93~0.99, P=0.01]; The incidence of tumors in patients with re-compensation was significantly lower than that in patients with continuous decompensation (HR=0.23, 95%CI: 0.37~0.57, P=0.02). Conclusion Compared with the baseline data of the patients with first decompensation, there were significant improvements in CTP score, Alb and Hb in the patients of re-decompensation group. Compared with the data of the continuous decompensation group, patients with younger age, lower CTP scores and MELD scores were more likely to achieve re-compensation, and the cumulative incidence of tumors in re-compensated patients was significantly lower than that in the continuous decompensation patients.

Key words: Hepatitis B cirrhosis, Esophageal and gastric fundus variceal, Recompensation, Liver cancer