[Study on the natural history of chronic hepatitis B].
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.
Wu
Guicheng
G
Institute for Viral Hepatitis of Chongqing University of Medical Sciences, Chongqing 400010, China.
Zhou
Weiping
W
Zhao
Yourong
Y
Guo
Shuhua
S
Wang
Zhiyi
Z
Zou
Shubi
S
Zhang
Quanhai
Q
Ren
Hong
H
Huang
AiIong
A
Zhang
Dingfeng
D
D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006513:Hepatitis B e Antigens / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000209:etiology; D017093:Liver Failure / Q000503:physiopathology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012723:Sex; D015996:Survival Rate
D006513:Hepatitis B e Antigens