Different natural courses of chronic hepatitis B with genotypes B and C after the fourth decade of life.
OBJECTIVE
To investigate the different impact of genotypes B and C on the development of liver cirrhosis (LC) among different age groups of patients with chronic hepatitis B (CH-B).


METHODS
We examined the outcome of 121 patients with CH-B, divided by age and genotype. Univariate analyses were used to compare different groups. The Cox proportional hazard model was employed to evaluate factors affecting the development of LC.


RESULTS
In patients < 30 years old, there were no significant predictors for development of LC. However, in patients > or = 30 years old, genotype C was the only significant predictor. In the genotype C group, 8 of 12 patients who progressed to LC were 30-49 years old at initial diagnosis of chronic hepatitis (7 patients were positive for HBeAg). In the genotype B group, 4 of 8 patients who developed LC were > or = 50 years old at initial diagnosis and were HBeAg-negative.


CONCLUSIONS
The rate of development of LC was comparable in patients infected with genotypes B and C when CH-B occurred at < 30 years old. However, CH-B patients infected with genotype C showed poor prognosis if they were 30-49 years old and were positive for HBeAg. Age-specific natural course of CH-B should be considered when patients with CH-B are treated with antiviral drugs.
Maeshiro
Tatsuji
T
Control and Prevention of Infectious Disease, Department of Medicine and Therapeutics, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, Japan. f994908@med.u-ryukyu.ac.jp
Arakaki
Shingo
S
Watanabe
Takako
T
Aoyama
Hajime
H
Shiroma
Joji
J
Yamashiro
Tsuyoshi
T
Hirata
Tetsuo
T
Hokama
Akira
A
Kinjo
Fukunori
F
Nakayoshi
Tomofumi
T
Nakayoshi
Tomokuni
T
Mizokami
Masashi
M
Fujita
Jiro
J
Sakugawa
Hiroshi
H
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000375:Aging; D004279:DNA, Viral; D018450:Disease Progression; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000175:diagnosis / Q000235:genetics / Q000276:immunology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000821:virology*; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
D004279:DNA, Viral; D006513:Hepatitis B e Antigens