| Title: |
Ishak stage 6 fibrosis is more likely to regress than stage 5 in CHB patients undergoing entecavir therapy |
| Authors: |
Mengjie Li; Xiaogang Hao; Yuanyuan Li; Chao Zhang; Yongping Chen; Zujiang Yu; Qin Li; Lin Tan; Dedong Xiang; Qinghua Shang; Chunliang Lei; Liang Chen; Xiaoyu Hu; Jing Wang; Huabao Liu; Wei Lu; Yan Chen; Zheng Dong; Wenlin Bai; Eric M. Yoshida; Nahum Mendez-Sanchez; Ke-Qin Hu; Xingshun Qi; Yongping Yang; Jingfeng Bi |
| Source: |
Frontiers in Medicine, Vol 13 (2026) |
| Publisher Information: |
Frontiers Media S.A. |
| Publication Year: |
2026 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
chronic hepatitis B; entecavir; fibrosis regression; Ishak stage; logistic regression; Medicine (General); R5-920 |
| Description: |
BackgroundChronic hepatitis B (CHB) patients with milder baseline fibrosis have traditionally been considered more likely to achieve histological improvement after antiviral therapy. However, our previous finding suggests that patients with Ishak stage 6 may have greater potential for fibrosis regression than those with stage 5. This study aimed to evaluate whether CHB patients with Ishak stage 6 are more likely to achieve fibrosis regression than those with stage 5 after entecavir (ETV) monotherapy or ETV in combination with Biejia-Ruangan (ETV + BR) therapy.MethodsBaseline Ishak fibrosis stage served as the main analytic variable, while the use of concomitant traditional Chinese medicine was included as a stratification factor. Demographic characteristics, viral markers, and baseline laboratory parameters were incorporated as covariates. A logistic regression model was applied to evaluate the association between baseline Ishak stage and fibrosis regression. Based on this model, a sensitivity analysis was further performed in the subgroup of patients with baseline Ishak stage 5 or 6 to assess the robustness of the findings. A generalized additive model (GAM) was additionally applied to explore potential non-linear stage-related patterns.ResultsA total of 705 patients had paired biopsy data. The fibrosis regression rate was 50.21% in stage 6 versus 45.58% in stage 5. In the multivariable logistic regression analysis, baseline Ishak stage 6 was associated with a higher likelihood of fibrosis regression compared with stage 5 (OR:1.612, 95%CI:1.027 ~ 2.529, p = 0.038). GAM analysis revealed a stage-related, non-linear trajectory with a nadir at stage 5 and an upward trend at stage 6. Sensitivity analyses yielded consistent results (OR: 1.835, 95%CI: 1.148 ~ 2.931, p = 0.011).ConclusionAmong CHB patients treated with ETV, those with baseline Ishak stage 6 were more likely to achieve histological fibrosis regression than those with stage 5.Clinical trial registrationIdentifier NCT01965418. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://www.frontiersin.org/articles/10.3389/fmed.2026.1765594/full; https://doaj.org/toc/2296-858X; https://doaj.org/article/3ec736d94fa54ae7ac5ce37bc30ea97b |
| DOI: |
10.3389/fmed.2026.1765594 |
| Availability: |
https://doi.org/10.3389/fmed.2026.1765594; https://doaj.org/article/3ec736d94fa54ae7ac5ce37bc30ea97b |
| Accession Number: |
edsbas.9E86A5D5 |
| Database: |
BASE |