Abstract
BACKGROUND: Chronic hepatitis B virus (HBV) infection is a global health issue with a significant impact on pregnant women, mainly due to the interplay between liver function and hematological changes. The liver plays a key role in erythropoiesis and systemic hemostasis. In HBeAg-positive pregnant women, platelet dynamics may be uniquely influenced by the interaction of HBV, immune modulation in pregnancy, and liver function. This area remains underexplored. OBJECTIVE: Our study aimed to analyze the interaction between HbeAg status with others preclinical factors by using the matrix correlation and multidimensional statistics methods. METHODS: We used SEM (Structural Equation Modeling) to demonstrate and quantify the direct reciprocal interaction between platelet count and HBeAg status in HBsAg-positive pregnant women. RESULTS: We found the quantity of platelet, with the optimal threshold is 201x10^3cells/ml, directly relates with HBeAg status (R =0.24) and negatively correlates with ratio of AST on ALT (R=-0.139). In case of HbeAg positive, the risk ratio having a high quantity of platelet (>201x103cells/ml) and high AST/ALT ratio (>1.42) is 2.16[1.23,3.80] (p<0.05). SEM model shows that platelet count has a direct impact on HBeAg (p<0.05, Coefficient =0.24) and indirectly through the AST/ALT ratio. This impact is greater than the direct impact from HBeAg on platelet count (p < 0.05, coefficient = 0.23). CONCLUSION: Research results show a complex relationship between platelet count, AST/ALT ratio and HBeAg in patients with chronic hepatitis B. The direct interaction between platelet count, HBeAg status, and AST/ALT ratio suggests intriguing complex immuno-biochemical responses to chronic hepatitis B virus (HBV) infection.