Hepatology International

, Volume 1, Issue 1, pp 267–273

Natural course following the onset of cirrhosis in patients with chronic hepatitis B: a long-term follow-up study

  • Yi-Cheng Chen
  • Chia-Ming Chu
  • Chau-Ting Yeh
  • Yun-Fan Liaw
Original Paper

DOI: 10.1007/s12072-007-5001-0

Cite this article as:
Chen, YC., Chu, CM., Yeh, CT. et al. Hep Intl (2007) 1: 267. doi:10.1007/s12072-007-5001-0

Abstract

Purpose

To elucidate the long-term natural course following the onset of cirrhosis in patients with chronic hepatitis B.

Methods

Ninety-three patients with chronic hepatitis B who had developed cirrhosis during regular follow-up were included in this long-term follow-up study. At the time of cirrhosis detection, 30% of the patients were seropositive for hepatitis B e antigen (HBeAg) and 73% had a HBV-DNA level >104 copies/ml. Follow-up studies included liver biochemistry, viral markers, α-fetoprotein and ultrasonography every 3–6 months.

Results

During a mean follow-up period of 102 ± 60 (12–246; median 97) months, 32 patients (34.4%) experienced 55 episodes of hepatitis flare (7.0%/year), 15 (53.6%) of 28 HBeAg-positive patients seroconverted to anti-HBe (6.3%/yr) and 12 (12.9%) lost HBsAg (1.5%/year). Overall disease progression was observed in 25 (26.9%, 3.2%/year) patients: 12 (12.9%, 1.5%/year) hepatic decompensation, 21 (22.6%, 2.7%/year) hepatocellular carcinoma and 11 (11.8%, 1.4%/year) died. Multivariate analysis showed that age at onset of cirrhosis (P = 0.015) and persistent HBeAg seropositivity (P = 0.019) were the independent factors for overall disease progression.

Conclusions

These results suggest that patients with older age at onset of cirrhosis and persistent HBeAg seropositivity following the onset of cirrhosis were independent factors for the disease progression in the first 10-year after the development of cirrhosis in patients with chronic hepatitis B.

Keywords

Hepatitis flare Hepatic decompensation Hepatocellular carcinoma HBeAg seroconversion HBsAg seroconversion 

Abbreviations

HBV

Hepatitis B virus

HCC

Hepatocellular carcinoma

HBeAg

Hepatitis e antigen

HBsAg

Hepatitis B surface antigen

HCV

Hepatitis C virus

HDV

Hepatitis D virus

AFP

α-Fetoprotein

ALT

Alanine aminotransferase

ULN

Upper limit of normal

PCR

Polymerase chain reaction

PT

Prothrombin time

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Yi-Cheng Chen
    • 1
  • Chia-Ming Chu
    • 1
  • Chau-Ting Yeh
    • 1
  • Yun-Fan Liaw
    • 1
  1. 1.Liver Research Unit, Chang Gung Memorial HospitalChang Gung UniversityTaipeiTaiwan

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