Hepatitis B virus (HBV) infection remains a major global health concern, predisposing patients to chronic liver disease, cirrhosis, and hepatocellular carcinoma. Chronic HBV infection is often accompanied by systemic and hepatic inflammatory responses. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have recently been proposed as accessible markers of systemic inflammation in several chronic diseases. However, their utility in HBV infection requires further clarification. This study aimed to evaluate NLR and PLR in HBV-infected individuals compared with healthy controls, and to explore their association with liver function indices.
A total of 100 participants were enrolled from the Azar Cohort, including 50 patients with chronic HBV infection and 50 age- and sex-matched healthy controls. Blood samples were analyzed for HBV serological markers (HBsAg, HBsAb, HBcAb), complete blood counts (WBC, neutrophils, lymphocytes, and platelets), and liver function tests. NLR and PLR were calculated, and their correlations with biochemical markers of liver injury were assessed.
No significant difference in platelet counts was observed between patients and controls (P=0.54). Neutrophil percentages were significantly reduced in patients, whereas lymphocyte percentages were elevated compared with healthy subjects (both P<0.05). Consequently, both NLR and PLR values were significantly decreased in HBV patients relative to controls (P<0.006 and P<0.01, respectively). These alterations reflect a shift in systemic inflammatory balance during HBV infection.
Our findings indicate that reduced NLR and PLR may serve as potential systemic inflammatory markers in patients with chronic HBV infection. These easily obtainable hematological indices could complement standard liver function tests in assessing inflammatory status and monitoring disease progression. Further large-scale, longitudinal studies are warranted to validate their prognostic utility in predicting clinical outcomes of HBV-related liver disease.
