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

Jinyu Wang; Tiantian Hu; Xiangyu Chi; Hao Wang; Yuqi Liu; Wentao Xie; Jiajia Han; Qian Qiu; Kangkang Yu; Chong Huang; Jubo Zhang; Qingchun Fu; Qi Miao; Zunguo Du; Haoxiang Zhu; Jiming Zhang

doi:10.1016/j.dld.2025.05.028

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

Dig Liver Dis. 2025 Jun 19:S1590-8658(25)00801-1. doi: 10.1016/j.dld.2025.05.028. Online ahead of print.

Authors

Jinyu Wang¹, Tiantian Hu¹, Xiangyu Chi¹, Hao Wang¹, Yuqi Liu¹, Wentao Xie¹, Jiajia Han¹, Qian Qiu¹, Kangkang Yu¹, Chong Huang¹, Jubo Zhang¹, Qingchun Fu², Qi Miao³, Zunguo Du⁴, Haoxiang Zhu⁵, Jiming Zhang⁶

Affiliations

¹ Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
² Department of Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
³ Department of Pathology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
⁴ Department of Pathology, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: duzunguo@fudan.edu.cn.
⁵ Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: haoxiangzhu2015@gmail.com.
⁶ Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China; Shanghai Institute of Infectious Diseases and Biosecurity, Key Laboratory of Medical Molecular Virology (MOE/MOH), Shanghai Medical College, Fudan University, Shanghai, China; Department of Infectious Diseases, Jing'An Branch of Huashan Hospital, Fudan University, Shanghai, China. Electronic address: jmzhang@fudan.edu.cn.

PMID: 40541511
DOI: 10.1016/j.dld.2025.05.028

Abstract

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.

Keywords: HBV; Portal hypertension; Porto-sinusoidal vascular disorder.