Abstract: Objective To analyze the incidence of cirrhosis and its relationship with the prognosis of patients with chronic hepatitis B (CHB). Methods This retrospective cohort study included 89 CHB patients admitted to the Second People′s Hospital of Taizhou City from May 2021 to May 2023. The levels of total bilirubin (TBil) and serum creatinine (Scr) were detected in all patients after admission by automatic biochemical analyzer. The prothrombin normalized ratio (INR) was measured by automatic coagulation analyzer. The patients were given antiviral, immunomodulatory, anti-inflammatory, antioxidant and liver protective treatment, and divided into a progression group and a non-progression group based on whether they developed into cirrhosis or not. The factors affecting the development of cirrhosis in CHB patients were analyzed and the evaluation value of ROC curve was analyzed. The patients were followed up for 1 year and divided into a good prognosis group and a poor prognosis group (death) according to the prognosis status of the patients. The factors affecting the poor prognosis of CHB patients were analyzed and their evaluation value was analyzed by ROC curve method. Results Among 89 patients with CHB, 19 patients (21.35%) developed cirrhosis. The level of PLT in the progression group was lower than that of the non-progression group (P<0.05) and the liver function of the progression group was grade C. By binary logistic regression analysis it was shown that the duration of disease (OR=2.169, 95%CI=1.349~3.489) and liver function grade of C (OR=4.350, 95%CI=1.456~12.993) were risk factors for cirrhosis in CHB patients, whereas the PLT level (OR=0.927, 95%CI=0.890~0.965) was a protective factor for cirrhosis in CHB patients (P<0.05). According to ROC curve analysis, the sensitivity of disease duration, PLT and liver function grade C to predict the cirrhosis progression in CHB patients were 78.90%, 73.70%, 47.40% and 89.50%, respectively; the specificity was 71.40%, 67.10%, 82.90% and 90.00%, respectively. Moreover, the combination of disease duration, PLT, and liver function grade C had a high value in predicting cirrhosis progression in CHB patients (AUC=0.899). Of the 89 patients with CHB, 15 had a poor prognosis (16.85%). Liver function grade C, TBil, INR and Scr levels in the poor prognosis group were higher than those in the good prognosis group (P<0.05). By Binary Logistic regression analysis, it was shown that TBil level (OR=1.032, 95%CI=1.013~1.052), INR level (OR=60.167, 95%CI=6.894~525.068), Scr level (OR=2.032, 95%CI:1.332~3.101), grade C liver function (OR=5.905, 95%CI=1.800~19.368) were the influential factors for poor prognosis in CHB patients (P<0.05). According to ROC curve analysis, the sensitivity of TBil, INR, Scr and liver function grade C to predict poor prognosis in CHB patients was 73.30%, 66.70%, 80.00%, 53.30% and 93.30%, respectively. The specificity was 74.30%, 77.00%, 71.60%, 83.80% and 89.20%, respectively. Moreover, the combination of TBil, INR, Scr and liver function grade C had a high value in predicting poor prognosis of CHB patients (AUC=0.894). Conclusion Long duration of disease, grade C liver function and PLT are the influencing factors for cirrhosis in CHB patients, and TBil, INR, Scr and liver function grade C are the influencing factors for poor prognosis in CHB patients. Early identification and correction of reversible factors are helpful to reduce the progression of cirrhosis and improve the prognosis of CHB patients.

Key words: Chronic hepatitis B, Liver cirrhosis, Prognosis