Objective: To investigate the clinical features and long-term prognosis of primary biliary cholangitis (PBC) in patients with past hepatitis B virus (HBV) infection. Methods: 353 cases with PBC who visited the Liver Disease Center of Beijing Friendship Hospital Affiliated to Capital Medical University between January 2000 and January 2018 were retrospectively analyzed and were divided into the past HBV infection group (156 cases) and the no HBV infection group (197 cases). The two groups' baseline clinical features were compared. Ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, and long-term liver transplantation-free survival rate were compared through outpatient and telephone follow-up. Results: PBC with past HBV infection had a significantly reduced female proportion compared to the no HBV infection group (91.9% vs. 79.5%, P = 0.001). However, there were no statistically significant differences in age, biochemical indices, immunological indicators, platelet count, cirrhosis proportion, and others. Ursodeoxycholic acid biochemical response rate was reduced in patients with past HBV infection at the end of one year of treatment, but the difference was not statistically significant (65.8% vs. 78.2%, P = 0.068). In addition, there were no statistically significant differences between the GLOBE score (0.57 vs. 0.59, P = 0.26) and UK-PBC 5-year (2.87% vs. 2.87%, P = 0.38), 10-year (9.29% vs. 8.2%, P = 0.39) and 15-year liver transplantation rates (16.6% vs. 14.73%, P = 0.39). Lastly, the overall 5-year liver transplantation-free survival rate had no statistically significant difference between the two groups of patients (86.4% vs. 87.5%, P = 0.796). Conclusion: Primary biliary cholangitis had no discernible effect in terms of age at onset, biochemical indices, immunological indicators, cirrhosis proportion, ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, or overall liver transplantation-free survival rate in patients with past hepatitis B virus infections.
目的： 探讨既往感染乙型肝炎病毒（HBV）的原发性胆汁性胆管炎（PBC）患者的临床特点及长期预后。 方法： 回顾性分析2000年1月至2018年1月于首都医科大学附属北京友谊医院肝病中心就诊的PBC患者353例，分为既往HBV感染组（156例）和无HBV感染组（197例）。比较两组患者的基线临床特点，并通过门诊及电话随访，比较其1年后对熊去氧胆酸应答率、GLOBE评分、UK-PBC评分以及长期无肝移植生存率。采用曼-惠特尼U检验比较既往HBV感染和无HBV感染PBC患者的生物化学指标、免疫球蛋白、血小板计数、GLOBE评分、UK-PBC评分等。采用χ(2)检验比较两组PBC患者性别、年龄、抗线粒体抗体-M2阳性率、肝硬化比例、熊去氧胆酸应答率。采用Kaplan-Meier方法计算患者的无肝移植生存率，组间比较用Log-rank对数秩检验。 结果： 与无HBV感染的PBC相比，既往HBV感染的PBC患者中女性比例显著降低（91.9%比79.5%，P = 0.001）；但在年龄、生物化学指标、免疫指标、血小板计数、肝硬化比例等方面差异无统计学意义。治疗1年时，既往HBV感染者对熊去氧胆酸生物化学应答率较低，但差异无统计学意义（65.8%比78.2%，P = 0.068）。此外，GLOBE评分（0.57比0.59，P = 0.26）以及UK-PBC 5年（2.87%比2.87%，P = 0.38）、10年（9.29%比8.20%，P = 0.39）及15年肝移植率（16.60%比14.73%，P = 0.39）差异亦无统计学意义。最后，两组患者5年总体无肝移植生存率（86.4%比87.5%，P = 0.796）差异无统计学意义。 结论： 既往HBV感染对PBC患者的发病年龄、生物化学指标、免疫指标、肝硬化比例、1年后熊去氧胆酸应答率、GLOBE评分、UK-PBC评分及总体无肝移植生存率方面均无明显影响。.
Keywords: Clinical outcome; Past HBV infection; Primary biliary cholangitis.