Survival in Chronic Hepatitis B

Abstract

Survival data from 379 patients with chronic hepatitis B were analyzed to determine life expectancy for the patient from the time of first contact. One hundred twenty-one patients had chronic persistent hepatitis, 128 had chronic active hepatitis, and 130 had chronic active hepatitis with cirrhosis. The frequency of symptoms (p less than 0.001), stigmata of chronic liver disease (p less than 0.001), and liver function test abnormalities (p less than 0.001) increased as the histologic features worsened, whereas the percentage of patients with circulating hepatitis B DNA polymerase declined (p less than 0.001). Women were uncommon in our series and had less severe disease than men (p less than 0.02). Fifty-one patients had died by the time of this analysis. The estimated 5-year survival rates were 97% for patients with chronic persistent hepatitis, 86% for those with chronic active hepatitis, and 55% for those with chronic active hepatitis with cirrhosis. The usual cause of death was liver failure and its sequelae. A multivariate analysis found age of 40 years or more, total bilirubin level of 1.5 mg/dL or more, ascites, and spider nevi to be factors that identified patients at a higher risk of death. The prognosis for patients with chronic hepatitis B is similar to that for patients with chronic hepatitis of other causes.

Natural history of chronic HBV infection: A cohort study with up to 12 years follow-up in North Greece (part of the Interreg I-II/EC-project)

“…Secondly, in studies that have evaluated asymptomatic patients, mostly blood donors aged <50 years and without histological follow-up, for a period ranging from 3.5 to 30 years, the estimated annual risk of cirrhosis and HCC was 0%-0.5% and 0%-0.2%, respectively [Dragosic et al, 1987;De Franchis et al, 1993;Villeneuve et al, [Weissberg et al, 1984;Fattovich et al, 1988;Fattovich et al, 1991;Hadziyannis et al, 1991;De Jongh et al, 1992]. Additionally, in areas with high endemicity of HBV infection, the risk of HCC in male patients who maintained HBeAg positivity at the age of 50 years was 1% per year [Yang et al, 2002].…”

“…However, these studies have no follow-up of histological activity. Some other studies have either evaluated a heterogeneous study population in relation to the severity of liver disease at enrollment [Weissberg et al, 1984;Liaw et al, 1988;De Jongh et al, 1992] or have included both treated and untreated patients [Di Marco et al, 1999] or have included selected groups such as blood donors [Dragosic et al, 1987;De Franchis et al, 1993;Manno et al, 2004]. Studies providing Information about the outcome of chronic HBV infection in the general population are lacking.…”

How to Predict HCC Development in Patients with Chronic B Viral Liver Disease?

“…Chronic necro-inflammation by persistent HBV infection can progress to cirrhosis and meanwhile genetic changes can lead to the occurrence of HCC [5]. Long-standing inflammatory activities may play an important role in the clinical course of HBV infection [6,7]. However, the long-term outcome of chronic hepatitis B based on the histological grade and stage in the natural clinical spectrum of chronic hepatitis B is still rare.…”

Factors Associated with Progression to Hepatocellular Carcinoma and to Death from Liver Complications in Patients with HBsAg-Positive Cirrhosis

“…There are few reports from the USA. In a previous study, the 5-year survival rate in 130 HBsAg-positive patients with cirrhosis was 55% [17,18]. In these cases, liver failure was the major cause of death and only three patients developed HCC.…”