Abstract: Objective The aim of this study was to investigate liver histological reversal in patients with hepatitis B-induced compensated liver cirrhosis (LC) after long-term treatment with entecavir (ETV). Methods 58 naïve patients with compensated hepatitis B cirrhosis were enrolled in our hospital between March 2015 and March 2019, and all received initial treatment with ETV for 5 to 9 years. Double liver biopsies at presentation and at time for follow-up were performed, and independent influencing factors on long-term histological improvement were analyzed by univariate and multivariate Logistic regression analysis. Results Of the 58 naïve patients with hepatitis B-induced LC, 35 individuals (60.3%) had liver histological improvement after 5 to 9 year antiviral treatment; percentages of alcohol intake and hepatitis B family history in those with histological reversal were 14.3% and 5.7%, both much lower than 52.2% and 39.1%(both P<0.05), age at enrollment was (41.8±9.3)yr, body mass index was (22.2±1.6)kg/m², both much younger or less than [(48.8±8.5) yr and (26.6±1.8)kg/m², P<0.05], serum HBV DNA load and antiviral treatment period were 5.6(4.1, 6.9)Ig IU/ml and 7.1(5.7, 9.1)yrs, significantly lower or longer than [7.8(6.1, 8.4)Ig IU/ml and 5.6(4.7, 6.1)yrs, P<0.05], LSM was 12.8(10.3, 15.1)kPa, much lower than [14.5(12.7, 20.3)kPa, P<0.05], and percentage of histological activity index (HAI) >G3 was 14.3%, much lower than 69.6%(P<0.05) in patients without histological reversal; multivariate Logistic regression analysis showed that age, serum HBV DNA loads at baseline, antiviral therapy period, LSM and HAI were all the independent impacting factors for long-term histological improvement (P＜0.05). Conclusion Early initiation and enough times of ETV antiviral treatment could improve liver histological injuries, and might obtain satisfactory outcomes in patients with compensated hepatitis B cirrhosis.

Key words: Liver cirrhosis, Hepatitis B, Entecavir, Histological reversal, Influencing factors