Hepatitis flare-related decompensation is associated with better outcomes in patients with chronic hepatitis B

Abstract Background & Aims The effects of baseline hepatitis flares (alanine transaminase level >5 times the upper limit of normal) on the outcomes of cirrhotic chronic hepatitis B (CHB) patients with decompensation treated with nucleos(t)ide analogues (Nucs) remain elusive; thus, we aimed to investigate these effects. Methods This 16-year cohort study monitored 511 consecutive cirrhotic CHB patients treated with Nucs for decompensation. Results Of the 511 patients, 399 (78.1%) were males, and 300 (58.7%) had baseline flares. Patients with flares had higher baseline levels of hepatitis B virus (HBV) DNA (6.44±1.52 vs. 6.08±1.46 log10 IU/mL, p=0.003), quantitative hepatitis B surface antigen, total bilirubin (bili-t), prolonged prothrombin time (δPT), platelet counts (108.0±42.9 vs. 83.6±44.7 103/μL, p Conclusions In decompensated, cirrhotic CHB patients treated with Nucs, a baseline hepatitis flare was independently associated with favorable long-term ( > 3 months) outcomes.