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The natural history of chronic hepatitis B: a retrospective study |
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 and Ding-Feng Zhang |
Chongqing, China
From the Department of Digestive Diseases, Chongqing Three Gorges Central Hospital, Wanzhou District, Chongqing 404000, China (Wu GC); Institute for Viral Hepatitis of Chongqing Medical University, Chongqing 400010, China (Zhou WP, Zhao YR, Guo SH, Wang ZY, Zou SB, Zhang QH, Ren H, Huang AL and Zhang DF)
Correspondence: Wei-Ping Zhou, MD, Institute for Viral Hepatitis of Chongqing Medical University, Chongqing 400010, China (Tel: 86-23-63706512; Fax: 86-23-63701383; Email: wuguicheng2002@hotmail.com) |
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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.
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