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

AbstractOBJECTIVE:
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.
AuthorsGui-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
JournalHepatobiliary & pancreatic diseases international : HBPD INT (Hepatobiliary Pancreat Dis Int) Vol. 2 Issue 4 Pg. 566-70 (Nov 2003) ISSN: 1499-3872 [Print] China
PMID14627521 (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

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