Abstract: Objective To investigate the status of adherence to hepatic fibrosis monitoring among patients with chronic hepatitis B and to analyze the factors associated with their monitoring behaviors. Methods A cross-sectional study was conducted among patients with chronic hepatitis B receiving care at the Fifth People's Hospital of Suzhou from February 2024 to May 2025. Adherence to hepatic fibrosis monitoring was assessed, and its potential influencing factors were analyzed. Results The rate of adherence to hepatic fibrosis monitoring was 38.07%. Logistic regression analysis revealed that several factors were significantly associated with monitoring adherence. These included per capita household income (OR=1.636), presence of comorbid chronic diseases (OR=2.173), a family history of liver cancer (OR=2.802), a family history of hepatitis B (OR=2.835), frequency of health education related to hepatic fibrosis within the past year (OR=3.670 and 7.338 for different frequencies), comorbid nonalcoholic fatty liver disease (OR=3.047), fear of disease progression (OR=2.136), and chronic disease self-efficacy (OR=2.153). Conclusion Adherence to hepatic fibrosis monitoring among patients with chronic hepatitis B is suboptimal. Adherence is associated with a range of factors, including socioeconomic status, comorbidities, family history, health education, fear of disease progression, and self-efficacy. Future interventions should target these determinants to improve monitoring adherence, thereby mitigating the progression to cirrhosis and hepatocellular carcinoma.

Key words: Chronic hepatitis B, Hepatic fibrosis, Monitoring, Adherence, Influencing factors