Prognostic value of neutrophil‐to‐lymphocyte ratio associated with prognosis in HBV‐infected patients

Abstract

Chronic severe hepatitis B (CSHB) is a critical clinical syndrome with a high mortality rate in China. The prognostic value of neutrophil to lymphocyte ratio (NLR) which is simple, low-cost, and useful inflammatory marker for hepatitis B virus (HBV)-infected patients is largely overlooked and without further exploration. This study assesses the association of NLR with prognosis of chronic hepatitis B (CHB) and CSHB patients. Two hundred and eighty subjects, including 79 with chronic hepatitis B (CHB) and 67 with chronic severe hepatitis B (CSHB), and 134 healthy individuals were retrospectively recruited into this study. Blood samples were collected to conduct liver function, prothrombin time activity (PTA), international normalized ratio (INR), HBV DNA measurement, and routine hematological testing. All patients were followed up for at least 3 months. NLR values in patients with CSHB (4.984 ± 3.608) and CHB (2.020 ± 1.182) were significantly higher than those in healthy control (1.638 ± 0.601) and patients with CSHB had the highest NLR values than CHB and healthy control. Increased NLR values were clinically associated with severe liver disease and higher mortality rate. NLR was found to be an independent predictor of mortality in multivariable Cox Regression models (HR = 3.912, 95%CI: 1.587-9.640, P = 0.003). NLR values are significantly increased in CHB and CSHB patients with the severity of liver disease. Moreover, NLR value is an independent predicting factor for the mortality rate in HBV-infected patients.

Neutrophil-lymphocyte ratio and mean platelet volume as predictive factors for liver fibrosis and steatosis in patients with chronic hepatitis B

“…Similar to the work by H. Liu et al, the current study found a negative correlation between NLR and disease aggravation [3]. J. Gong et al presents results consistent with the presented observations, indicating that NLR is reversely correlated with disease aggravation [11]. Higher values of this marker were observed in more severely sick patients.…”

“…In chronic hepatitis B, the NLR was evaluated in this study as a predictive factor for hepatic fibrosis and steatosis. Attempts were made to introduce the NLR into the diagnostics and monitoring of such diseases as Hodgkin's lymphoma [4,5,6], diffuse large B-cell Lymphoma [7], gastric cancer or acute venous thrombosis [8,9,10,11]. Furthermore, everyday clinical practice is faced with the so-far underestimated problem of liver steatosis.…”

Neutrophil Extracellular Traps in Digestive Cancers: Warrior or Accomplice

“…Hepatitis virus infection is widely known as a common cause of liver cancer. Related studies revealed that the peripheral NLR of patients with chronic hepatitis B is positively correlated with disease severity and mortality (161). A recent study showed that HBV infection can inhibit the release of NETs from neutrophils by regulating the levels of cellular ROS and autophagy to maintain chronic liver inflammation (162).…”

Induction of interleukin 6 impairs the anti‐HBV efficiency of IFN‐α in human hepatocytes through upregulation of SOCS3

“…Hepatitis B virus (HBV) is an enveloped virus belonging to the hepadnaviridae family and possessing a partially double‐stranded circular DNA genome . HBV infection is one of the major global public health problems with over 240 million chronically infected individuals worldwide . Chronic hepatitis B virus (CHB) infection is correlated with high risk of developing liver fibrosis, cirrhosis, and hepatocellular carcinoma .…”

“…1,2 HBV infection is one of the major global public health problems with over 240 million chronically infected individuals worldwide. 3 Chronic hepatitis B virus (CHB) infection is correlated with high risk of developing liver fibrosis, cirrhosis, and hepatocellular carcinoma. 4,5 Currently, interferon-α (IFN-α) is one of the most commonly used treatment for HBV infection.…”