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The development of cirrhosis in patients with chronic type B hepatitis: A prospective study
Author(s) -
Liaw YunFan,
Tai DarIn,
Chu ChiaMing,
Chen TongJong
Publication year - 1988
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840080310
Subject(s) - medicine , cirrhosis , gastroenterology , seroconversion , hbeag , exacerbation , decompensation , hepatitis b , hepatitis b virus , incidence (geometry) , hepatitis , superinfection , virus , immunology , hbsag , physics , optics
The incidence and contributing factors of cirrhosis developing in patients with chronic type B hepatitis were assessed prospectively in 684 clinicopathologically verified patients, of which 509 were HBeAg positive and 175 were anti‐HBe positive at entry into the study. During an average follow‐up period of 35.3 months, cirrhosis occurred 6 to 64 months after entry in 35 HBeAg‐positive and 7 anti‐HBe positive patients with a calculated annual incidence of 2.4 and 1.3%, respectively (p > 0.05). The incidence increased significantly with the increasing age at entry. Patients who had experienced (a) hepatic decompensation, (b) repeated episodes of severe acute exacerbation (with α‐fetoprotein > 100 ng per ml and/or bridging hepatic necrosis), (c) severe acute exacerbation not accompanied by subsequent HBeAg seroconversion and (d) hepatitis B virus reactivation (particularly those with HBeAg reappearance) were found to develop cirrhosis much more frequently (p < 0.001). Contrary to general belief, patients who had hepatitis delta virus superinfection and patients with chronic active hepatitis were not particularly prone to develop cirrhosis. We conclude that in addition to age factor, the extent, severity, duration, frequency and etiology of the hepatic lobular alterations are important factors for the development of cirrhosis in patients with chronic type B hepatitis.