Objective To study the prognosis of patients with chronic hepatitis B combined with metabolic-associated fatty liver disease (MAFLD) after receiving antiviral therapy, and to analyze influencing factors for poor prognosis. Methods A total of 98 patients with chronic hepatitis B combined with MAFLD were selected and divided into a good prognosis group (60 cases) or a poor prognosis group (38 cases) according to the outcomes of antiviral therapy. The general clinical data of patients were collected, and the multivariate logistic regression model was used to analyze influencing factors for poor prognosis of patients with chronic hepatitis B combined with MAFLD after antiviral therapy. Results After antiviral therapy, the incidence of poor prognosis in patients with chronic hepatitis B combined with MAFLD was 38.78%. There were statistically significant differences in the proportions of patients with a history of diabetes, hypertension, hyperlipidemia, and liver cirrhosis; model of end-stage liver disease (MELD) score; and high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, total cholesterol, triacylglycerol (TAG), alanine transaminase, aspartate transaminase, creatinine, and blood urea nitrogen levels between the good prognosis group and the poor prognosis group(all P<0.05). The results of multivariate logistic regression analysis showed that diabetes, hypertension, and hyperlipidemia history, a high TAG level, liver cirrhosis, and a high MELD score were independent risk factors for the poor prognosis of patients with chronic hepatitis B combined with MAFLD after antiviral therapy, and a high HDL-C level was a protective factor (all P<0.05). Conclusion In patients with chronic hepatitis B combined with MAFLD, poor prognosis after antiviral therapy is common, diabetes, hypertension, and hyperlipidemia history, a high TAG level, liver cirrhosis, and a high MELD score are independent risk factors for poor prognosis after antiviral therapy, and a high HDL-C is a protective factor.

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