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CN 22-1108/R
Volume 42 Issue 1
Jan.  2026
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Article Navigation >  Journal of Clinical Hepatology  > 2026  >  42(1): 90-100

Influencing factors for recompensation and its impact on the prognosis in patients with decompensated liver cirrhosis

DOI: 10.12449/JCH260111

  • Department of Hepatology，Yunnan Provincial Clinical Medical Center for Infectious Diseases，The Third People’s Hospital of Kunming，Kunming 650041，China

Research funding:

Science and Technology Program Fund of Yunnan Province (2017FH001-088);

Project of the Science and Technology Plan of Kunming City (2025-NS-028);

Kunming Municipal Health Science Research Project (2025-03-08-002)

More Information
  • Corresponding author: LIU Li， liuli197210@163.com （ORCID： 0000-0001-7712-4931）; YANG Yongrui， 595144613@qq.com （ORCID： 0009-0002-4707-2557）
  • Received Date: 2025-08-06
  • Accepted Date: 2025-09-03
  • Published Date: 2026-01-25
    Abstract
  •   Objective  To investigate the influencing factors for recompensation in patients with decompensated liver cirrhosis， as well as the impact of recompensation on the prognosis of such patients， and to provide a basis for early identification of high-risk patients in clinical practice.  Methods  A retrospective analysis was performed for the clinical data of patients who attended The Third People’s Hospital of Kunming from January 2016 to December 2022 and were diagnosed with decompensated liver cirrhosis due to hepatitis B， hepatitis C， alcoholic hepatitis， and autoimmune hepatitis， and they were divided into recompensation group and persistent decompensation group. To control for confounding factors， whether recompensation occurred was used as the rouping variable，and BMI， alcohol consumption history， HIV infection history， TG， CHOL， LDL， and HDL were used as covariates. The propensity score was calculated， and 1：1 nearest neighbor matching was performed with a caliper value of 0.1. After propensity score matching， the recompensation group and the persistent decompensation group with relatively balanced covariates were obtained. Univariate and multivariate Cox proportional-hazards regression model analyses were used to investigate the influencing factors for recompensation； the “rms” package was used to establish a nomogram； the receiver operating characteristic （ROC） curve was plotted to calculate the area under the ROC curve （AUC）； the Hosmer-Lemeshow test was used to assess the goodness of fit of the model； the “Calibration Curves” package was used to plot calibration curves for model assessment. The Kaplan-Meier method was used to plot survival curves， and the Log-rank test was used for comparison of survival curves.  Results  Among the 863 patients with decompensated liver cirrhosis， 305 experienced recompensation， resulting in an incidence rate of 35.3%. After PSM， 610 cases were successfully matched， with 305 cases in each group. The univariate and multivariate Cox regression analyses showed that etiology （hepatitis C： hazard ratio［HR］=0.288， P=0.002）； male（HR=0.701， P=0.016）， age（HR=0.988， P=0.047）， hemoglobin （HGB）（HR=1.006， P=0.017）， and CD4 T cell（HR=1.001，P=0.047）， TIPS procedure （HR=1.808，P=0.042） were independent influencing factors for recompensation in patients with decompensated liver cirrhosis. During follow-up， 116 patients died of liver disease-related causes， with 27 patients （8.85%） in the recompensation group and 89 （15.95%） in the persistent decompensation group； 109 patients developed HCC， with 23 patients （7.54%） in the recompensation group and 86 （15.41%） in the persistent decompensation group. The Kaplan-Meier survival curves showed significant separation between the patients with different states of compensation in terms of liver disease-related mortality rate and the incidence rate of HCC， and the Log-rank test showed that there were significant differences between the two groups in liver disease-related mortality rate （χ2=9.023， P=0.003） and the incidence rate of HCC （χ2=10.526， P=0.001）.  Conclusion  Etiology，sex，age，TIPS，HGB，and CD4 T cell are independent influencing factors for recompensation in patients with decompensated liver cirrhosis. There is a significant difference in the incidence rate of recompensation between decompensated liver cirrhosis patients with different etiologies， and female patients and patients with a younger age，a history of TIPS， a higher HGB level， and a higher CD4 lymphocyte count are more likely to experience recompensation. Recompensation is the key to improving the long-term prognosis of patients and can significantly reduce long-term liver disease-related mortality rate and the incidence rate of HCC.

     

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    • References(32)
  • [1]
    Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the management of ascites in cirrhosis(2023 version)[J]. Chin J Hepatol, 2023, 31( 8): 813- 826. DOI: 10.3760/cma.j.cn501113-20230719-00011.

    中华医学会肝病学分会. 肝硬化腹水诊疗指南(2023年版)[J]. 中华肝脏病杂志, 2023, 31( 8): 813- 826. DOI: 10.3760/cma.j.cn501113-20230719-00011.
    [2]
    WANG Q, ZHAO H, DENG Y, et al. Validation of Baveno VII criteria for recompensation in entecavir-treated patients with hepatitis B-related decompensated cirrhosis[J]. J Hepatol, 2022, 77( 6): 1564- 1572. DOI: 10.1016/j.jhep.2022.07.037.
    [3]
    DENG Y, KANG HY, XIANG HL, et al. Durability and on-treatment predictors of recompensation in entecavir-treated patients with hepatitis B and decompensated cirrhosis[J]. JHEP Rep, 2024, 6( 7): 101091. DOI: 10.1016/j.jhepr.2024.101091.
    [4]
    RUAN JJ, WEN SF, WANG X, et al. Influencing factors for recompensation in patients with first-time decompensated hepatitis B cirrhosis[J]. J Clin Hepatol, 2022, 38( 8): 1796- 1800. DOI: 10.3969/j.issn.1001-5256.2022.08.015.

    阮佳佳, 温世飞, 王霞, 等. 首次失代偿期乙型肝炎肝硬化患者获得再代偿的影响因素分析[J]. 临床肝胆病杂志, 2022, 38( 8): 1796- 1800. DOI: 10.3969/j.issn.1001-5256.2022.08.015.
    [5]
    Chinese Society of Hepatology, Chinese Medical Association. Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines for the prevention and treatment of hepatitis C(2022 version)[J]. Chin J Infect Dis, 2023, 41( 1): 29- 46. DOI: 10.3760/cma.j.cn311365-20230217-00045.

    中华医学会肝病学分会, 中华医学会感染病学分会. 丙型肝炎防治指南(2022年版)[J]. 中华传染病杂志, 2023, 41( 1): 29- 46. DOI: 10.3760/cma.j.cn311365-20230217-00045.
    [6]
    Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B(version 2022)[J]. Infect Dis Info, 2023, 36( 1): 1- 17. DOI: 10.3969/j.issn.1007-8134.2023.01.01.

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2022年版)[J]. 传染病信息, 2023, 36( 1): 1- 17. DOI: 10.3969/j.issn.1007-8134.2023.01.01.
    [7]
    Fatty Liver Expert Committee, Chinese Medical Doctor Association, National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association. Guidelines of prevention and treatment for alcoholic liver disease:a 2018 update[J]. J Clin Hepatol, 2018, 34( 5): 939- 946. DOI: 10.3969/j.issn.1001-5256.2018.05.006.

    中国医师协会脂肪性肝病专家委员会, 中华医学会肝病学分会脂肪肝和酒精性肝病学组. 酒精性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34( 5): 939- 946. DOI: 10.3969/j.issn.1001-5256.2018.05.006.
    [8]
    Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the diagnosis and management of autoimmune hepatitis(2021)[J]. J Clin Hepatol, 2022, 38( 1): 42- 49. DOI: 10.3969/j.issn.1001-5256.2022.01.008.

    中华医学会肝病学分会. 自身免疫性肝炎诊断和治疗指南(2021)[J]. 临床肝胆病杂志, 2022, 38( 1): 42- 49. DOI: 10.3969/j.issn.1001-5256.2022.01.008.
    [9]
    DAI EH, GUO XR, WANG JT, et al. Investigate of the etiology and prevention status of liver cirrhosis[J]. Natl Med J China, 2023, 103( 12): 913- 919. DOI: 10.3760/cma.j.cn112137-20221017-02164.

    戴二黑, 郭心如, 王继涛, 等. 肝硬化的病因及防治现状调查[J]. 中华医学杂志, 2023, 103( 12): 913- 919. DOI: 10.3760/cma.j.cn112137-20221017-02164.
    [10]
    HUI VW, WONG GL, WONG VW, et al. Baveno VII criteria for recompensation predict transplant-free survival in patients with hepatitis B-related decompensated cirrhosis[J]. JHEP Rep, 2023, 5( 9): 100814. DOI: 10.1016/j.jhepr.2023.100814.
    [11]
    ZHANG YH, LIU X, LI S, et al. Risk of HCC decreases in HBV-related patients with cirrhosis acquired recompensation: A retrospective study based on Baveno VII criteria[J]. Hepatol Commun, 2024, 8( 1): e0355. DOI: 10.1097/HC9.0000000000000355.
    [12]
    HE ZY, WANG BQ, WU XN, et al. Recompensation in treatment-naïve HBV-related decompensated cirrhosis: A 5-year multi-center observational study comparing patients with ascites and bleeding[J]. Hepatol Int, 2023, 17( 6): 1368- 1377. DOI: 10.1007/s12072-023-10579-w.
    [13]
    PREMKUMAR M, DHIMAN RK, DUSEJA A, et al. Recompensation of chronic hepatitis C-related decompensated cirrhosis following direct-acting antiviral therapy: Prospective cohort study from a hepatitis C virus elimination program[J]. Gastroenterology, 2024, 167( 7): 1429- 1445. DOI: 10.1053/j.gastro.2024.08.018.
    [14]
    SEMMLER G, LENS S, HIDALGO Á, et al. Incidence and clinical significance of recompensation after HCV cure[J]. Clin Gastroenterol Hepatol, 2025: S1542-S3565(25)00414- 8. DOI: 10.1016/j.cgh.2025.04.026.
    [15]
    XU DQ, MU H, ZHANG YY, et al. Influencing factors for recompensation in patients with decompensated hepatitis C cirrhosis[J]. J Clin Hepatol, 2025, 41( 2): 269- 276. DOI: 10.12449/JCH250212.

    许丹青, 木唤, 张映媛, 等. 丙型肝炎肝硬化失代偿患者再代偿的影响因素分析[J]. 临床肝胆病杂志, 2025, 41( 2): 269- 276. DOI: 10.12449/JCH250212.
    [16]
    HOFER BS, SIMBRUNNER B, HARTL L, et al. Hepatic recompensation according to Baveno VII criteria is linked to a significant survival benefit in decompensated alcohol-related cirrhosis[J]. Liver Int, 2023, 43( 10): 2220- 2231. DOI: 10.1111/liv.15676.
    [17]
    ZHANG P. Clinical characteristics and related factors research for recompensation in decompensated liver cirrhosis[D]. Chengdu: University of Electronic Science and Technology of China, 2024.

    张培. 失代偿期肝炎肝硬化再代偿临床特征及相关影响因素研究[D]. 成都: 电子科技大学, 2024.
    [18]
    HOFER BS, BURGHART L, HALILBASIC E, et al. Evaluation of potential hepatic recompensation criteria in patients with PBC and decompensated cirrhosis[J]. Aliment Pharmacol Ther, 2024, 59( 8): 962- 972. DOI: 10.1111/apt.17908.
    [19]
    DING SY, LU SY, LI JN, et al. Analysis of drinking patterns and risk factors for ascites in patients with alcoholic cirrhosis[J]. Trauma and Crit Medicine, 2025, 13( 5): 321- 325. DOI: 10.16048/j.issn.2095-5561.2025.05.01.

    丁思元, 卢盛言, 李佳宇, 等. 酒精性肝硬化患者饮酒模式与腹水发生的危险因素分析[J]. 创伤与急危重病医学, 2025, 13( 5): 321- 325. DOI: 10.16048/j.issn.2095-5561.2025.05.01.
    [20]
    XU XM, WANG HL, ZHAO WL, et al. Recompensation factors for patients with decompensated cirrhosis: A multicentre retrospective case-control study[J]. BMJ Open, 2021, 11( 6): e043083. DOI: 10.1136/bmjopen-2020-043083.
    [21]
    TONON M, GAGLIARDI R, POMPILI E, et al. Validation and expansion of Baveno VII recompensation criteria in patients with cirrhosis and curable liver disease[J]. J Hepatol, 2025, 83( 4): 888- 898. DOI: 10.1016/j.jhep.2025.04.018.
    [22]
    KUMAR A, MISHRA SR, SHARMA P, et al. Clinical, laboratory, and hemodynamic parameters in portal hypertensive gastropathy: A study of 254 cirrhotics[J]. J Clin Gastroenterol, 2010, 44( 4): 294- 300. DOI: 10.1097/MCG.0b013e3181b37ea1.
    [23]
    SINGH S, MANRAI M, PARVATHI VS, et al. Association of liver cirrhosis severity with Anemia: Does it matter?[J]. Ann Gastroenterol, 2020, 33( 3): 272- 276. DOI: 10.20524/aog.2020.0478.
    [24]
    ZHANG LL, DING XQ, YANG L. Effect of Anemia on prognosis in elderly patients with HBV-related decompensated cirrhosis[J]. J Navy Med, 2024, 45( 4): 408- 412. DOI: 10.3969/j.issn.1009-0754.2024.04.020.

    张玲玲, 丁小琴, 杨丽. 贫血对老年乙型肝炎病毒相关失代偿期肝硬化患者预后的影响[J]. 海军医学杂志, 2024, 45( 4): 408- 412. DOI: 10.3969/j.issn.1009-0754.2024.04.020.
    [25]
    RUDOLPH KL, CHANG S, MILLARD M, et al. Inhibition of experimental liver cirrhosis in mice by telomerase gene delivery[J]. Science, 2000, 287( 5456): 1253- 1258. DOI: 10.1126/science.287.5456.1253.
    [26]
    WANG YX, WU CY, ZHOU JH, et al. Overexpression of estrogen receptor β inhibits cellular functions of human hepatic stellate cells and promotes the anti-fibrosis effect of calycosin via inhibiting STAT3 phosphorylation[J]. BMC Pharmacol Toxicol, 2022, 23( 1): 77. DOI: 10.1186/s40360-022-00617-y.
    [27]
    LI M, SU JT, WU SS, et al. Correlation among age, sex, and liver diseases-related mortality risk in patients with hepatitis B virus-related liver cirrhosis[J]. Chin J Hepatol, 2021, 29( 5): 403- 408. DOI: 10.3760/cma.j.cn501113-20201224-00676.

    李敏, 苏健婷, 武珊珊, 等. 乙型肝炎肝硬化患者年龄和性别与肝病相关死亡风险的关系[J]. 中华肝脏病杂志, 2021, 29( 5): 403- 408. DOI: 10.3760/cma.j.cn501113-20201224-00676.
    [28]
    CHANG XJ, LI YY, SUN C, et al. High-risk population of progressive hepatic fibrosis in chronic hepatitis B patients on antiviral therapy[J]. J Gastroenterol, 2023, 58( 5): 481- 493. DOI: 10.1007/s00535-023-01970-3.
    [29]
    ZHU NN, JIAO SN, ZHANG YS, et al. Analysis of influencing factors and predictive efficacy of recompensation in patients with decompensated hepatitis B cirrhosis[J]. Shandong Med J, 2025, 65( 6): 67- 72. DOI: 10.3969/j.issn.1002-266X.2025.06.014.

    朱宁宁, 焦淑宁, 张域爽, 等. 乙型肝炎肝硬化失代偿期患者再代偿的影响因素及其预测效能分析[J]. 山东医药, 2025, 65( 6): 67- 72. DOI: 10.3969/j.issn.1002-266X.2025.06.014.
    [30]
    LI X, ZHAO PP, WANG FB, et al. An analysis of the relationship between child- pugh score and cellular immune function in patients with hepatitis B cirrhosis[J]. Labeled Immunoass Clin Med, 2022, 29( 6): 932- 934. DOI: 10.11748/bjmy.issn.1006-1703.2022.06.008.

    李欣, 赵培培, 王富兵, 等. 乙肝后肝硬化患者Child-Pugh分级与细胞免疫功能相关性分析[J]. 标记免疫分析与临床, 2022, 29( 6): 932- 934. DOI: 10.11748/bjmy.issn.1006-1703.2022.06.008.
    [31]
    SÁNCHEZ J, GONZÁLEZ S, POYATOS P, et al. Recompensation after TIPS reduces the incidence of hepatocellular carcinoma and increases survival in patients with cirrhosis[J]. Liver Int, 2024, 44( 11): 3072- 3082. DOI: 10.1111/liv.16095.
    [32]
    BAI Y, LIU J, LEI Y, et al. Recompensation after transjugular intrahepatic portosystemicshunt reduces mortality risk: A long-term follow-up study[J]. Eur J Radiol, 2025, 190: 112212. DOI: 10.1016/j.ejrad. 2025.112212.
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