LIVER, PANCREAS & BILIARY TRACT: Original ArticleHBeAg Negativity Is Associated With More Advanced Liver Fibrosis in Patients With Chronic Hepatitis B A Propensity Score-Matching AnalysisWang, Jian MD, PhD*; Wu, Weihua MD*; Yan, Xiaomin MD*; Wei, Jie MD†; Yao, Kefang MD†; Yang, Yue MD*; Xiong, Yali MD, PhD*; Xia, Juan MD*; Liu, Yong PhD‡; Chen, Yuxin PhD‡; Jia, Bei MD*; Zhang, Zhaoping MD*; Ding, Weimao MD§; Huang, Rui MD, PhD*; Wu, Chao MD, PhD* Author Information *Department of Infectious Diseases ‡Department of Laboratory Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School †Department of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing §Department of Hepatology, Huai’an No. 4 People’s Hospital, Huai’an, Jiangsu, China J.W. and W.W. contributed equally. Supported by the National Science and Technology Major Project of China (2018ZX10302205), National Natural Science Foundation of China (81672025 and 81702011), Medical Science and Technology Development Foundation of Nanjing (ZDX16004 and YKK16118) and Natural Science Foundation of Jiangsu Province for Young Scholar (BK20160121), Jiangsu Science and Technology Development Plan (BE2017605), Jiangsu Provincial Medical Innovation Team (CXTDA2017005) and Nanjing Medical Science and Technique Development Foundation (QRX17121). The authors declare that they have nothing to disclose. Address correspondence to: Chao Wu, MD, PhD and Rui Huang, MD, PhD, Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu 210008, China (e-mails: [email protected], [email protected]). Journal of Clinical Gastroenterology 54(9):p 826-831, October 2020. | DOI: 10.1097/MCG.0000000000001291 Buy Metrics Abstract Background: Serum hepatitis B e antigen (HBeAg) status is associated with the progression of chronic hepatitis B (CHB). The authors aimed to investigate the relationship between HBeAg status and liver pathology in CHB patients. Methods: A total of 683 treatment-naive CHB patients who had undergone liver biopsy were retrospectively enrolled from 2 medical centers. Propensity score-matching (PSM) method was performed to adjust the imbalance of baseline confounders between HBeAg-positive and HBeAg-negative CHB patients. Results: HBeAg-negative CHB patients (n=338) exhibited more advanced liver fibrosis than HBeAg-positive CHB patients (n=345) before PSM (P<0.001). However, there were no significant differences in the distribution of inflammation grades between HBeAg-positive and HBeAg-negative CHB patients (P=0.051). Of these 683 CHB patients, 123 patients were included in each group after PSM. HBeAg-negative CHB patients still showed significantly advanced liver fibrosis as compared with HBeAg-positive CHB patients (P=0.03) after PSM. Furthermore, the distribution of liver inflammation grades in the HBeAg-negative CHB patients was also more severe than patients with HBeAg-positive (P=0.037). HBeAg-negative status was identified as an independent risk factor of significant liver fibrosis (P=0.011) by multivariate analysis. Conclusions: HBeAg negativity is associated with more advanced liver fibrosis in CHB patients. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.