title: Clinical management of chronic hepatitis B infection: results from a registry at a German tertiary referral center.
abstract: OBJECTIVE
  We studied a cohort of adult patients with chronic hepatitis B (CHB) infection, followed at a tertiary referral liver center in Germany over 12.5 years to analyze the clinical features and impact of management on disease progression and survival of CHB patients in general and of those with CHB and HCC in particular.
  
  
  METHODS
  We retrospectively evaluated the medical records of 242 adult (age ≥ 18 years) patients. CHB was defined as positive hepatitis B surface antigen (HBsAg) and/or HBV-DNA levels >10 IU/mL for at least 6 months. Patient demographics, HBV markers, antiviral treatment, laboratory parameters, liver imaging and histology were recorded for each visit. HCC patients were divided into two groups and separately analyzed (group 1: n = 24, HCC at first visit and group 2: n = 11, HCC during surveillance).
  
  
  RESULTS
  The mean age was 44 years in CHB patients without HCC (63% male) and about 59 years in patients with HCC (77% male). Antiviral therapy was given to 59% of patients without HCC compared to only 25% in group 1 and 18% in group 2 with comparable median HBV DNA levels of approximately 36,000 IU/mL. There was no statistically significant difference concerning the HCC stages (Milan, UCSF, BCLC) at first diagnosis. Five-year survival was 19% in group 1 vs. 64% in group 2 (p = 0.019), with LTx performed in 12 vs. 45%, respectively.
  
  
  CONCLUSIONS
  Surveillance of CHB patients did not result in early stage detection of HCC but in a higher likelihood to receive potentially curative treatments.
authors.affiliation: Clinic for Gastroenterology and Hepatology, University Hospital of Cologne, 50924, Cologne, Germany, muenevver.demir@uk-koeln.de.
authors.forename: M
authors.initials: M
authors.lastname: Demir
authors.forename: J
authors.initials: J
authors.lastname: Nigemeier
authors.forename: F
authors.initials: F
authors.lastname: Kütting
authors.forename: A
authors.initials: A
authors.lastname: Bowe
authors.forename: C
authors.initials: C
authors.lastname: Schramm
authors.forename: V
authors.initials: V
authors.lastname: Hoffmann
authors.forename: D
authors.initials: D
authors.lastname: Waldschmidt
authors.forename: T
authors.initials: T
authors.lastname: Goeser
authors.forename: H-M
authors.initials: HM
authors.lastname: Steffen
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011159:Population Surveillance; D012042:Registries; D012189:Retrospective Studies; D062606:Tertiary Care Centers