Risk factors contributing to polyneuropathy in chronic hepatitis B: a cross-sectional perspective

During the course of chronic hepatitis B (CHB), polyneuropathy (PNP) may occur. The purpose of this study is to investigate risk factors and determine the frequency of PNP in CHB patients who have complaints such as pain, paresthesia, and numbness.

The data of 350 CHB patients who presented to the neurology outpatient clinic with symptoms suggestive of PNP were retrospectively analyzed. Sociodemographic and disease-related data and nerve conduction studies (NCS) results were obtained from hospital records.

PNP was found in 59 out of 350 patients. Out of these individuals, 72.9 % had axonal PNP and 27.1 % had demyelinating PNP. High hepatic activity index (HAI) score (OR = 2.74, 95 % CI: [1.63;4.72], p < 0.001), HBeAg-negative CHB (OR = 5.46, 95 % CI: [1.78;16.87], p = 0.003), male gender (OR = 7.53, 95 % CI: [3.71;15.91], p < 0.001), and advanced age (OR = 1.07, 95 % CI: [1.03;1.10], p < 0.001) were identified as independent risk factors linked to PNP. Male participants were significantly more common in the axonal PNP group (p = 0.003), while female participants predominated in the demyelinating PNP group. Disease duration was significantly longer in the demyelinating PNP group (p = 0.025). The Ishak Fibrosis Score (IFS), which reflects the severity of fibrosis, was significantly higher in the axonal group (p < 0.001).

Our results reveal that male gender, high HAI score, advanced age and HBeAg positivity are risk factors for PNP in CHB. Male patients who have severe liver fibrosis face a higher likelihood of developing PNP, characterized by substantial axonal damage. Conversely, female individuals with a prolonged history of CHB are susceptible to demyelinating injury. Consequently, it is advantageous to inquire about PNP problems in CHB patients during their routine examinations and, if warranted, to arrange a NCS and provide guidance for diagnosis and therapy.