Unstable Recompensation: An Intermediate Subtype in Patients With HBV-Related Decompensated Cirrhosis

Area of Science:

• Hepatology
• Viral Hepatitis
• Cirrhosis Research

Background:

• Hepatitis B virus (HBV)-related decompensated cirrhosis patients achieving recompensation can still experience further decompensation.
• Recompensation status is dynamic and requires further classification.

Purpose of the Study:

• To classify patterns of recompensation in HBV-related decompensated cirrhosis.
• To characterize clinical differences among recompensation subgroups.

Main Methods:

• Patients with HBV-related decompensated cirrhosis were followed for up to 5 years.
• Recompensation was defined by Baveno VII criteria and categorized as stable or unstable.
• Clinical characteristics and complications were assessed every 6 months.

Main Results:

• Of 378 patients, 294 (77.8%) achieved recompensation.
• Stable recompensation occurred in 53.4% and unstable in 24.3%.
• Unstable recompensation showed higher 5-year rates of hepatocellular carcinoma (HCC) or mortality (14.7%) compared to stable recompensation (10.1%).

Conclusions:

• Recompensation is not uniform and requires subclassification into stable and unstable states.
• Unstable recompensation is associated with poorer survival than stable recompensation.
• Outcomes for unstable recompensation remain better than for ongoing decompensation.