Insights into the coexistence of Wilson’s disease and chronic hepatitis B: A retrospective propensity score matched study for improving clinical practice

Background and aims: Early and accurate diagnosis of the coexistence of Wilson’s disease (WD) and chronic hepatitis B (CHB) presents a significant challenge for clinicians. The objective of this study was to retrospectively analyse the characteristics of such patients to improve clinical practice an...

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Main Authors: Jiahui Pang, Shuru Chen, Yingfu Zeng, Yutian Chong, Weiqiang Gan, Xinhua Li
Format: Article
Language:English
Published: KeAi Communications Co., Ltd. 2025-06-01
Series:Liver Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S2542568424000849
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author Jiahui Pang
Shuru Chen
Yingfu Zeng
Yutian Chong
Weiqiang Gan
Xinhua Li
author_facet Jiahui Pang
Shuru Chen
Yingfu Zeng
Yutian Chong
Weiqiang Gan
Xinhua Li
author_sort Jiahui Pang
collection DOAJ
description Background and aims: Early and accurate diagnosis of the coexistence of Wilson’s disease (WD) and chronic hepatitis B (CHB) presents a significant challenge for clinicians. The objective of this study was to retrospectively analyse the characteristics of such patients to improve clinical practice and provide a reference for clinical management. Methods: From January 2011 to December 2022, 35 patients with concurrent CHB and WD (CHB + WD group) were identified. A total of 127 patients with CHB (CHB group) and 168 patients with WD (WD group) were included in the control group between January 2016 and December 2021. Propensity score matching (PSM) was performed to balance the baseline values between groups. The Kaplan–Meier (K–M) survival analysis and log-rank test were performed to compare the prognoses. Results: In the cohort of 35 patients with concurrent CHB and WD, 74.3% of patients (26 patients) faced a substantial delay of up to 10 years (range: 0–40 years) in WD diagnosis following their CHB diagnosis. Twenty-three (65.7%) patients had cirrhosis at the time of WD diagnosis, and 26 (74.3%) patients experienced liver failure. The levels of serum copper and uric acid were lower in patients in the CHB + WD group than in those in the CHB group. Patients in the CHB + WD group presented higher alanine transaminase and total bile acid levels compared to those in the WD group. K–M survival analysis indicated that patients with CHB and WD had poorer outcomes than those with CHB alone; however, the outcomes were similar to those of individuals with WD alone. The optimal cut-point of serum ceruloplasmin (CP) in identifying WD in CHB patients was 0.10 g/L before PSM and after PSM. Conclusions: The present study emphasizes the importance of clinicians being vigilant for concurrent CHB and WD diagnoses, as delays in WD diagnosis may adversely affect patient outcomes. CHB patients with serum CP below 0.10 g/L are highly recommended to screen for WD.
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spelling doaj-art-facb7cd171eb436a80815cfff60decb42025-08-20T02:10:24ZengKeAi Communications Co., Ltd.Liver Research2542-56842025-06-019216917710.1016/j.livres.2024.12.003Insights into the coexistence of Wilson’s disease and chronic hepatitis B: A retrospective propensity score matched study for improving clinical practiceJiahui Pang0Shuru Chen1Yingfu Zeng2Yutian Chong3Weiqiang Gan4Xinhua Li5Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, ChinaCorresponding author.; Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, ChinaCorresponding author.; Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, ChinaBackground and aims: Early and accurate diagnosis of the coexistence of Wilson’s disease (WD) and chronic hepatitis B (CHB) presents a significant challenge for clinicians. The objective of this study was to retrospectively analyse the characteristics of such patients to improve clinical practice and provide a reference for clinical management. Methods: From January 2011 to December 2022, 35 patients with concurrent CHB and WD (CHB + WD group) were identified. A total of 127 patients with CHB (CHB group) and 168 patients with WD (WD group) were included in the control group between January 2016 and December 2021. Propensity score matching (PSM) was performed to balance the baseline values between groups. The Kaplan–Meier (K–M) survival analysis and log-rank test were performed to compare the prognoses. Results: In the cohort of 35 patients with concurrent CHB and WD, 74.3% of patients (26 patients) faced a substantial delay of up to 10 years (range: 0–40 years) in WD diagnosis following their CHB diagnosis. Twenty-three (65.7%) patients had cirrhosis at the time of WD diagnosis, and 26 (74.3%) patients experienced liver failure. The levels of serum copper and uric acid were lower in patients in the CHB + WD group than in those in the CHB group. Patients in the CHB + WD group presented higher alanine transaminase and total bile acid levels compared to those in the WD group. K–M survival analysis indicated that patients with CHB and WD had poorer outcomes than those with CHB alone; however, the outcomes were similar to those of individuals with WD alone. The optimal cut-point of serum ceruloplasmin (CP) in identifying WD in CHB patients was 0.10 g/L before PSM and after PSM. Conclusions: The present study emphasizes the importance of clinicians being vigilant for concurrent CHB and WD diagnoses, as delays in WD diagnosis may adversely affect patient outcomes. CHB patients with serum CP below 0.10 g/L are highly recommended to screen for WD.http://www.sciencedirect.com/science/article/pii/S2542568424000849Chronic hepatitis B (CHB)Wilson’s disease (WD)CoexistenceCeruloplasmin (CP)Clinical practicePrognosis
spellingShingle Jiahui Pang
Shuru Chen
Yingfu Zeng
Yutian Chong
Weiqiang Gan
Xinhua Li
Insights into the coexistence of Wilson’s disease and chronic hepatitis B: A retrospective propensity score matched study for improving clinical practice
Liver Research
Chronic hepatitis B (CHB)
Wilson’s disease (WD)
Coexistence
Ceruloplasmin (CP)
Clinical practice
Prognosis
title Insights into the coexistence of Wilson’s disease and chronic hepatitis B: A retrospective propensity score matched study for improving clinical practice
title_full Insights into the coexistence of Wilson’s disease and chronic hepatitis B: A retrospective propensity score matched study for improving clinical practice
title_fullStr Insights into the coexistence of Wilson’s disease and chronic hepatitis B: A retrospective propensity score matched study for improving clinical practice
title_full_unstemmed Insights into the coexistence of Wilson’s disease and chronic hepatitis B: A retrospective propensity score matched study for improving clinical practice
title_short Insights into the coexistence of Wilson’s disease and chronic hepatitis B: A retrospective propensity score matched study for improving clinical practice
title_sort insights into the coexistence of wilson s disease and chronic hepatitis b a retrospective propensity score matched study for improving clinical practice
topic Chronic hepatitis B (CHB)
Wilson’s disease (WD)
Coexistence
Ceruloplasmin (CP)
Clinical practice
Prognosis
url http://www.sciencedirect.com/science/article/pii/S2542568424000849
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