Abstract: Objective To analyze the clinicopathological features and perform regression in analysis in patients with chronic hepatitis B (CHB) and concurrent primary biliary cholangitis(PBC). Methods Between February 2017 and December 2022, we collected data from 105 patients diagnosed with PBC who underwent liver biopsy at our hospital, including those with concurrent CHB. The diagnoses of PBC and CHB were confirmed according to established criteria. We compared demographic data, laboratory tests, serum antibody levels, immunoglobulin, and complement levels between the CHB-combined and non-CHB-combined groups. Additionally, we analyzed the pathological characteristics of liver biopsies from both groups. Patients were followed for one year to assess treatment responses, which were then compared between the two groups. Results Among patients with PBC, 7 cases (43.7%) presented with ascites and 13 cases (81.2%) had cirrhosis, significantly higher than those without concurrent CHB, where 17 cases (19.1%) had ascites and 46 cases (51.7%) had cirrhosis( P<0.05). In the CHB group, PLT, ALP, GGT, TG and INR were recorded as follows: 93 (81, 157) × 10⁹/L, 180 (124, 309) U/L, 146 (64, 311) U/L, 1.2 (1.0, 1.6) mmol/L, 1.3(1.2, 1.5), respectively. These values were significantly different from the non- CHB group, which showed PLT at 137 (78, 215) × 10⁹/L, ALP at 132 (75, 178) U/L, GGT at101 (51, 170) U/L, TG at 0.9 (0.7, 1.1) mmol/L, and INR at 1.0 (0.8, 1.1)(P<0.05). The positive rates of ANA and anti-gp210 antibodies in patients with CHB were 15 cases (93.7%) and 7 cases (43.7%), respectively, which were higher than in patients without CHB, where the rates were 62 cases (69.7%) and 15 cases (16.8%)(P<0.05). Serum immunoglobulin levels in the CHB group were significantly elevated, with IgG at 17.9(13.9, 21.2) g/L, IgA at 3.6(2.6, 5.2) g/L, and IgM at 2.5(1.2, 3.5) g/L, comparednto the non-CHB group, which had IgG at 16.4 (12.7, 20.0) g/L, IgA at 3.2 (2.3, 4.5) g/L, and IgM at 2.2 (1.7, 2.9) g/L(P<0.05). Pathological features observed in the 105 PBC patients included interfacial hepatitis in 66 cases(62.8%), bridging necrosis in 27 cases (25.7%), inflammatory cell infiltration in the portal area in 92 cases(87.6%), intrahepatic cholestasis in 19 cases(18.1%), bile duct injury in 12 cases(11.4%), rosette formation in 9 cases (8.6%). After one year of treatment, the response rates were 11 cases (68.7%) in the CHB group and 67 cases (75.3%) in the non-CHB group. Conclusion Patients with PBC complicated by CHB are at increased risk of immune dysfunction, characterized by elevated immunoglobulin levels and decreased complement levels. Monitoring changes in these immune function-related indicators can aid in assessing the condition and prognosis of PBC in clinical practice.

Key words: Chronic hepatitis B, Primary biliary cholangitis, Clinicopathological features, Regression