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- Title
Effect of hepatitis B and C virus infections on the natural history of compensated cirrhosis: a cohort study of 297 patients
- Authors
Fattovich, Giovanna; Pantalena, Maurizio; Zagni, Irene; Realdi, Giuseppe; Schalm, Solko W.; Christensen, Erik
- Abstract
OBJECTIVES:The aim of this study was to compare the prognosis of patients with hepatitis B surface antigen(HBsAg) positive and those with antibody to hepatitis C (anti-HCV) positive cirrhosis.METHODS:This was a retrospective cohort study of 297 untreated Western European patients with compensated viral cirrhosis (Child class A; 161 patients with hepatitis type B and 136 with type C) who were followed for a median period of 6.6 yr.RESULTS:At diagnosis, median age was lower (48 vs 58 yr, respectively) in HBsAg-positive cirrhotic patients. The Kaplan-Meier 5-yr probability of hepatocellular carcinoma (HCC) was 9% and 10% in HBsAg and anti-HCV-positive cirrhotic patients, respectively; the corresponding figures for decompensation unrelated to HCC were 16% and 28% and for survival were 86% and 84%, respectively. After adjustment for clinical and serological differences at baseline, the relative risk (95% CI) for HCC, decompensation and mortality was 1.53 (CI = 0.81–2.89), 0.59 (CI = 0.37–0.94), and 1.44 (CI = 0.85–2.46) respectively, in HBsAg-positive patients compared with anti-HCV-positive cirrhotic patients. Among HBsAg-positive cirrhotic patients, the relative risk for HCC, decompensation, and mortality was 0.89 (CI = 0.30–2.63), 4.05 (CI = 1.09–15.1), and 5.9 (CI = 1.64–21.3), respectively, in HBV-DNA positive (HBeAg positive or negative) compared with HBV-DNA negative (HBeAg negative) patients at entry.CONCLUSIONS:Patients with HBV infection may present with cirrhosis about 10 yr earlier than those with HCV infection. HCV infection tends to be associated with a higher risk of decompensation, but these data should take into consideration the heterogeneity of HBV-related cirrhosis in terms of viremia levels and risk of hepatic failure. Survival shows no significant differences according to HBV or HCV etiology in Western European cirrhotic patients.
- Subjects
CIRRHOSIS of the liver; HEPATITIS B; HEPATITIS C; PROGNOSIS; PATIENTS
- Publication
American Journal of Gastroenterology (Springer Nature), 2002, Vol 97, Issue 11, p2886
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.2002.07057.x