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

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