HBeAg Negativity is Associated with a Higher Risk of Liver-Related Death in Patients with Chronic Hepatitis B Related Liver Cirrhosis

Few studies reported the association between the survival of patients with chronic hepatitis B (CHB)-related liver cirrhosis (LC) and hepatitis B e antigen (HBeAg) state. Three hundred and ninety-eight CHB-LC patients from two institutions were included. To adjust for selection bias, propensity score matching (PSM) with 1:1 ratio was used to balance clinical features between HBeAg-positive and HBeAg-negative CHB-LC patients. The related factors of liver-related death were identified by cox regression analysis, while the difference of survival was analyzed using Kaplan–Meier curves. Two hundred and eighty-eight (72.4%) CHB-LC patients were HBeAg negative, and the median follow-up time was 33.9 months. Fifty-two liver-related deaths occurred during the follow-up period. The liver-related mortality in HBeAg-negative CHB-LC patients was comparable with HBeAg-positive patients before PSM (14.2% vs. 22.3%, P = 0.094). After PSM for age, sex, platelet count, ALT level, and HBV DNA, 77 patients were matched in each group. Higher liver-related mortality was observed in patients with HBeAg-negative CHB-LC than those of HBeAg-positive CHB-LC patients (39.6% vs. 18.7%, P = 0.019). Patients with decompensated LC had similar results. Furthermore, HBeAg-negative state was identified as a significantly risk factor of liver-related mortality (HR, 3.032; 95% CI, 1.232–7.460; P = 0.016). HBeAg-negative state may be an independent risk factor of liver-related mortality in patients with CHB-LC.