Bacterial infection adversely increases the risk of decompensation in patients with hepatitis B virus-related compensated cirrhosis: a retrospective study

BMC Infect Dis. 2024 Dec 19;24(1):1446. doi: 10.1186/s12879-024-10306-2.

Abstract

Background: Hepatitis B virus related compensated cirrhosis generally has a favorable prognosis until decompensation occurs. Bacterial infections are prevalent in Hepatitis B virus related decompensated cirrhosis.Bacterial infection and decompensated hepatitis B cirrhosis are mutually reinforcing. And it also interacts with and promotes certain decompensation-related events. However, the impact of bacterial infections on the progression from compensated to decompensated cirrhosis in Hepatitis B patients remains unclear.

Methods: We retrospectively analyzed the baseline characteristics of 1,011 patients with Hepatitis B virus related compensated cirrhosis. Using time-dependent regression analysis, we evaluated whether bacterial infections increase the risk of decompensation, defined as the occurrence of ascites, hepatic encephalopathy, or variceal bleeding.

Results: A total of 1,011 patients were retrospectively analyzed over a median follow-up period of 79 months. Bacterial infections were observed in 89 patients (8.8%). Respiratory and urinary tract infections were the most common bacterial infections.Decompensation occurred in 44.9% of patients with bacterial infections, compared to 9% of those without BIs. Patients with bacterial infections had a higher risk of decompensation ([OR] 1.024; 95% CI 1.016-1.032; p < 0.001) than those without bacterial infections.

Conclusion: Our findings suggest that bacterial infections have a significant impact on the progression of hepatitis B virus related compensated cirrhosis, notably increasing the risk of decompensation.

Keywords: Bacterial infection; Compensated cirrhosis; Decompensated cirrhosis; Diagnosis; Hepatitis B virus; Progression; Risk factor.

MeSH terms

  • Adult
  • Aged
  • Ascites / complications
  • Ascites / microbiology
  • Bacterial Infections* / complications
  • Bacterial Infections* / epidemiology
  • Bacterial Infections* / microbiology
  • Disease Progression
  • Female
  • Hepatic Encephalopathy / complications
  • Hepatic Encephalopathy / epidemiology
  • Hepatic Encephalopathy / virology
  • Hepatitis B / complications
  • Hepatitis B / virology
  • Hepatitis B virus
  • Hepatitis B, Chronic / complications
  • Humans
  • Liver Cirrhosis* / complications
  • Liver Cirrhosis* / virology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors