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

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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.

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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

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Authors and Affiliations

  1. Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University, 199, Tung Hwa North Road, Taipei, 105, Taiwan

    Yi-Cheng Chen, Chia-Ming Chu, Chau-Ting Yeh & Yun-Fan Liaw

Authors
  1. Yi-Cheng Chen
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  2. Chia-Ming Chu
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  3. Chau-Ting Yeh
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  4. Yun-Fan Liaw
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Corresponding author

Correspondence to Yun-Fan Liaw.

Additional information

This work was supported by grants from National Science Council, Taiwan (NSC95-2314-B-182A-032) and the Prosperous Foundation, Taipei, Taiwan.

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Chen, YC., Chu, CM., Yeh, CT. et al. Natural course following the onset of cirrhosis in patients with chronic hepatitis B: a long-term follow-up study. Hep Intl 1, 267–273 (2007). https://doi.org/10.1007/s12072-007-5001-0

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