Dynamic changes in controlled attenuation parameter (CAP) improve prognostic prediction for CHB patients with significant fibrosis and cirrhosis.

Authors

Xiaowei Ai, Mengyang Zhang, Shuyan Chen, Xinyu Zhao, Jialing Zhou, Tongtong Meng, Bingqiong Wang, Chenglin Sun, Xiao Han, Yankun Gao, Xiaoning Wu, Hong You, Yameng Sun

Published in

Hepatology international. Sep 19, 2026. Epub Sep 19, 2026.

Abstract

The coexistence of hepatic steatosis and chronic hepatitis B (CHB) is becoming increasingly common. Although the controlled attenuation parameter (CAP) has been widely used to quantify hepatic steatosis in CHB patients, the prognostic value of longitudinal changes in CAP remains unknown. This study aimed to evaluate whether dynamic changes in CAP are associated with liver-related events (LREs) in CHB patients undergoing antiviral therapy.
CHB patients with significant fibrosis or cirrhosis before antiviral therapy were included. CAP was used to assess hepatic steatosis. LREs were defined as hepatic decompensations, hepatocellular carcinoma (HCC), liver transplantation, or liver-related death. Joint models were employed to analyze associations between longitudinal measurements and risk of LREs.
A total of 573 CHB patients were followed for a median of 6.9 years, during which 51 LREs occurred. CAP-dynamics independently predicted LREs (per 10 dB/m increase aHR 0.86, 95% CI 0.78-0.96, p = 0.006). After adjusting for LSM-dynamics, CAP-dynamics remained an independent factor for LREs (per 10 dB/m increase aHR 0.85, 95% CI 0.77-0.95, p = 0.005). The multivariate joint model integrating CAP and LSM dynamics improved predictive performance compared with LSM alone, with the 7-year AUROC increasing from 0.70 to 0.75. CAP exceeding 236 dB/m over time was associated with a reduced risk of LREs (aHR 0.67, 95% CI 0.53-0.84, p < 0.001).
In on-treatment CHB patients with significant fibrosis, the dynamics of CAP were associated with the risk of LREs. Longitudinal monitoring of CAP can offer extra prognostic value.

PMID:
42762383
Bibliographic data and abstract were imported from PubMed on 20 Sep 2026.

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