The natural history of chronic hepatitis B: a retrospective study.

Abstract

OBJECTIVE:

To clarify the natural history of chronic hepatitis B so as to evaluate its long-term therapeutic outcome of the patients and the efficacy of antiviral drugs.

METHODS:

A cohort of 183 biopsy-proven chronic hepatitis B patients (mean age of 31.75+/-8.03 years, male/female ratio: 152:31) and 247 controls were followed up retrospectively for 11.81+/-4.08 years. This study was focused on long-term clinical outcome including the rates of liver cirrhosis, hepatocellular carcinoma and death, apart from the long-term effect of antiviral drugs and prognostic factors.

RESULTS:

In the 183 chronic hepatitis B patients, 22 (12.02%) developed liver cirrhosis, 12 (6.56%) developed hepatocellular carcinoma, and 20 (10.93%) died. The 5-, 10- and 15-year survival rates were 97.27%, 91.62%, and 84.47%, respectively. The 5-, 10- and 15-year incidence rates of HCC were 0, 3.19%, and 11.56%, respectively. In the 247 controls, 6 (2.43%) died; none of them developed cirrhosis or HCC. The rates of death, liver cirrhosis, and HCC in the hepatitis B patients were markedly different (P<0.005) compared with the controls. The overall mortality of hepatitis B patients was 4.5-fold higher than the general population. Cox multiple regression analysis showed that old age, severe histological injury, and positive HBeAg were closely related to liver cirrhosis; old age, severe histological injury, and male were major factors leading to death. The independent variable of predicted HCC was not found.

CONCLUSION:

The long-term outcome of hepatitis B patients is poor and the efficacy of antiviral drugs needs further study.

• Authors: Gui-Cheng Wu, Wei-Ping Zhou, You-Rong Zhao, Shu-Hua Guo, Zhi-Yi Wang, Shu-Bi Zou, Quan-Hai Zhang, Hong Ren, Ai-Long Huang, Ding-Feng Zhang
• Journal: Hepatobiliary & pancreatic diseases international : HBPD INT (Hepatobiliary Pancreat Dis Int) Vol. 2 Issue 4 Pg. 566-70 (Nov 2003) ISSN: 1499-3872 [Print] Singapore
• PMID: 14627521 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Age Distribution
• Aged
• Biopsy, Needle
• Carcinoma, Hepatocellular (epidemiology, pathology, therapy)
• Case-Control Studies
• Disease Progression
• Female
• Follow-Up Studies
• Hepatitis B, Chronic (epidemiology, pathology, therapy)
• Humans
• Immunohistochemistry
• Incidence
• Liver Cirrhosis (epidemiology, pathology, therapy)
• Liver Neoplasms (epidemiology, pathology, therapy)
• Male
• Middle Aged
• Precancerous Conditions (pathology)
• Probability
• Proportional Hazards Models
• Reference Values
• Retrospective Studies
• Risk Assessment
• Sex Distribution
• Survival Analysis
• Time Factors