Long-term outcome of chronic hepatitis B based on histological grade and stage.
OBJECTIVE
This study evaluated the long-term outcome and prognostic factors of chronic hepatitis B, based on histological grade and stage.


METHODS
A total of 188 patients with chronic hepatitis B were followed for a mean 119.8 months. Ultrasonography and clinical assessment were performed regularly. In addition, liver biopsy specimens were re-evaluated based on histological grade and stage.


RESULTS
During follow-up, cirrhosis developed in 62 patients, decompensation in 20 patients, and hepatocellular carcinoma (HCC) in 21 patients. The serum alanine aminotransferase (ALT) level at the time of liver biopsy was significantly correlated with the grades of lobular and porto-periportal activity. The development of cirrhosis correlated well with the grade of porto-periportal activity and stage of fibrosis. The probabilities of developing cirrhosis, decompensation and HCC were significantly higher in patients whose ALT levels were persistently elevated without flares or flared-up without normalization than in patients whose ALT levels flared-up then normalized or were normally sustained. By multivariate analysis, age and biochemical profile during follow-up were independent prognostic factors for chronic hepatitis B.


CONCLUSIONS
The results demonstrate that histological grade and stage, and biochemical profile during follow-up in patients with chronic hepatitis B are important prognostic factors. Therefore, effective control of hepatitis activity might improve the long-term outcome of chronic hepatitis B patients.
Park
Byung Kyu
BK
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Park
Young Nyun
YN
Ahn
Sang Hoon
SH
Lee
Kwan Sik
KS
Chon
Chae Yoon
CY
Moon
Young Myoung
YM
Park
Chanil
C
Han
Kwang-Hyub
KH
D000328:Adult; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000473:pathology*; D006801:Humans; D008297:Male; D011379:Prognosis; D013997:Time Factors