[A retrospective cohort study on the natural history of chronic hepatitis Beta in Shanghai, China].
OBJECTIVE
To describe the natural history of chronic hepatitis Beta in patients with chronic hepatitis Beta (CHB) in Shanghai, China.


METHODS
322 cases with biopsy-proven CHB diagnosed from 1981 to 1993 were retrospectively studied. Medical records since the original diagnosis were reviewed and final examination was performed on those who were still living. Survival analysis including life table, Kaplan-Meier method and Log-Rank test was applied to compare the survival rates, and un-happen rates of decompensated cirrhosis and hepatocellular carcinoma between the groups with compensated cirrhosis and without cirrhosis at the original diagnosis. Standardized mortality ratio (SMR) was calculated to reflect the death risks from total death, hepatic disease death and liver cancer death.


RESULTS
For CHB without cirrhosis group, the incidence of decompensated cirrhosis and hepatocellular carcinoma were 6.7 per thousand person-year and 2.8 per thousand person-year,respectively. The mortality was 7.6 per thousand person-year. The 5-, 10-, 15- year survival rates were 95.9%, 93.0% and 87.9%, respectively. The 5-, 10-, 15-year decompensated cirrhosis un-happen rates were 97.1%, 95.4% and 88.9%, respectively. The SMRs of total death, liver cancer death and hepatic diseases death were 2.50, 9.73 and 80.38, respectively. For CHB with compensated cirrhosis group, the incidence of decompensated cirrhosis and hepatocellular carcinoma were 35.6 per thousand person-year and 8.2 per thousand person-year, respectively. The mortality was 35.2 per thousand person-year. The 5-, 10-, 15- year survival rates were 85.3%, 69.0% and 55.8%, respectively. The 5-, 10-, 15-year decompensated cirrhosis un-happen rates were 82.0%, 63.8%, and 58.7%, respectively. The SMRs of total death, liver cancer death and hepatic diseases death were 8.09, 30.30 and 312.50, respectively.


CONCLUSIONS
CHB with compensated cirrhosis group had a significantly lower survival rates and lower un-happen rates of decompensated cirrhosis as compared with CHB without cirrho s is group through Log-Rank tests. Both groups had remarkable high SMRs of total death, liver cancer death and hepatic disease death.
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China.
Biao
B
Xu
Dechang
D
Hu
Rosenberg
R
Daniel
Qingwu
Q
Jiang
Ximin
X
Lin
Jialiang
J
Lu
Xuliang
X
Li
D002681:China; D015331:Cohort Studies; D005260:Female; D019694:Hepatitis B, Chronic / Q000401:mortality*; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality; D008107:Liver Diseases / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality; D008297:Male; D012189:Retrospective Studies