Unveiling the clinical spectrum of Porto-Sinusoidal Vascular Disorder (PSVD) with chronic HBV infection: insights from a retrospective Chinese cohort.

Background: Porto-Sinusoidal Vascular Disorder (PSVD) is a non-cirrhotic vascular liver disease associated with or without signs of portal hypertension (PH). Chronic hepatitis B virus (HBV) infection frequently coexists with PSVD, but its clinical impact remains unclear. This study investigates the clinical and histopathological features of PSVD with and without chronic HBV infection.

Methods: Liver biopsy records of 2007 patients from Huashan Hospital, Shanghai, China (2017-2024), were reviewed, identifying 73 cases of PSVD, of which 31 had concurrent chronic HBV infection. Clinical, histological, and imaging data were analyzed from diagnosis to follow-up. A matched analysis by age and gender compared PSVD patients with and without HBV infection.

Results: HBV prevalence among PSVD patients (43.1%) was significantly higher than in the general population (6.1%, < 0.0001). HBV-positive patients had lower nodular regenerative hyperplasia (p = 0.008) and higher nonzonal sinusoidal dilation (p = 0.068). The HBV-negative group had higher BMI and more severe PH manifestations, including varices and portosystemic collaterals (p < 0.0001). Liver enzyme levels differed significantly between groups (p < 0.05).

Conclusion: HBV-infected PSVD patients exhibit milder PH and distinct histopathological features. Routine PSVD screening is recommended in long-term HBV management.