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.
Subject(s)
Carcinoma, Hepatocellular/pathology , Hepatitis B, Chronic/pathology , Liver Cirrhosis/pathology , Liver Neoplasms/pathology , Precancerous Conditions/pathology , Adult , Age Distribution , Aged , Biopsy, Needle , Carcinoma, Hepatocellular/epidemiology , Carcinoma, Hepatocellular/therapy , Case-Control Studies , Disease Progression , Female , Follow-Up Studies , Hepatitis B, Chronic/epidemiology , Hepatitis B, Chronic/therapy , Humans , Immunohistochemistry , Incidence , Liver Cirrhosis/epidemiology , Liver Cirrhosis/therapy , Liver Neoplasms/epidemiology , Liver Neoplasms/therapy , Male , Middle Aged , Probability , Proportional Hazards Models , Reference Values , Retrospective Studies , Risk Assessment , Sex Distribution , Survival Analysis , Time FactorsABSTRACT
OBJECTIVE: To evaluate their long-term outcome and the efficacy and economic significance of antiviral drugs by investigating the long-term health-related quality of life (HQL) in chronic hepatitis B (CHB) patients. METHODS: The HQL of 101 CHB patients with biopsy-proven 6 to 18 years ago and 105 persons of general population as control was studied with revised SF-36 questionnaire. RESULTS: The HQL in CHB patients was lower than that in general population in physical functioning, role physical, general health, mental health, and specific symptoms (mu > or = 2.10, P<0.05). CONCLUSIONS: The long-term HQL in chronic hepatitis B patients is poor.
Subject(s)
Cost of Illness , Hepatitis B, Chronic , Quality of Life , Adolescent , Adult , Antiviral Agents/therapeutic use , Female , Follow-Up Studies , Hepatitis B, Chronic/drug therapy , Hepatitis B, Chronic/economics , Humans , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
OBJECTIVE: By clarifying the natural history of chronic hepatitis B, to evaluate its long-term therapeutic outcome, antiviral drugs efficacy and economic significance. METHODS: A cohort of 183 (mean age of 31.75?.03 years, male/female ratio: 152:31) chronic hepatitis B patients with biopsy-proven and 247 cases of general population as control were followed up by retrospective cohort study. The follow-up time was 11.81?.08 years. This study was focused on long-term clinical outcome including the rate of liver cirrhosis, hepatocellular carcinoma and death, the long-term effect of antiviral drugs and prognostic factors. RESULTS: In chronic hepatitis B patients, 22 (12.02%) developed liver cirrhosis, 12 (6.56%) hepatocellular carcinoma, and 20 (10.93%) died. The cumulative survival probabilities were 97.27%, 91.62%, and 84.47% in 5, 10, and 15 years, respectively. The cumulative probabilities of HCC were 0.00%, 3.19%, and 11.56% in 5, 10, and 15 years, respectively. In 247 control subjects, 6 (2.43%) died, none of them developed cirrhosis or HCC. The rates of death, liver cirrhosis, and HCC in hepatitis B patients were markedly different (P<0.005) compared with controls. The overall mortality of hepatitis B patients was 4.50 folds of the general population. Cox multiple regression analysis showed that old age, severe histological injury, and the positive HBeAg were closely related to liver cirrhosis, while old age, severe histological injury, and male were major factors leading to death. The independent variable of predicted HCC was not found. CONCLUSIONS: The long-term outcome of hepatitis B is poor.
