Correlation between virological response and portal vein thrombosis in patients with chronic hepatitis B

Portal vein thrombosis (PVT) is an important complication of liver cirrhosis, especially in patients with chronic hepatitis B (CHB). Previous studies have revealed that hepatitis B virus (HBV) infection and several serological indicators are associated with PVT; however, no predictive model including virological indicators of PVT in cirrhosis patients with CHB has been established. A retrospective cohort study including 252 CHB patients at the Affiliated Hospital of Qingdao University between January 1, 2012, and December 31, 2023, was performed. Baseline data were collected. PVT outcomes and antiviral virological responses were subsequently evaluated. We recognized risk factors and their hazard ratios. Propensity score matching (PSM) analysis was used to control for confounding factors. A clinical predictive model of PVT in CHB patients was established and verified. During a median follow-up time of 2568 days, 28 patients (11.11%) developed PVT. There were significant differences in age, portal vein diameter, spleen major axis, antiviral therapy time, prothrombin time (PT), blood platelet count, aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), alpha-feto protein (AFP), D-dimer, international normalized ratio (INR), low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (TC), serum hepatitis B virus deoxyribonucleic acid (HBV DNA) loads and levels after antiviral therapy, complications associated with hepatocellular cell cancer cirrhosis level, and antiviral responses between PVT patients and non-PVT patients. The effect of antiviral therapy was worse in more severe cirrhosis. There were greater PVT risks in patients with VBT antiviral responses, larger major axes in the spleen, and higher hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb) levels. After controlling for confounding factors with PSM analysis, there was still a higher PVT risk in patients with adverse virological responses. A predictive nomogram for PVT in CHB patients was established and validated. PVT is a common complication in cirrhosis patients with CHB. Favorable virological responses are beneficial for lowering the risk of PVT in CHB patients. HCC, virological response, age, portal vein diameter, splenic major axis, PT, PLT, HBsAg, and HBsAb can be used to predict PVT in CHB patients.