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Clinical features and survival in Chinese patients with hepatitis B e antigen‐negative hepatitis B virus‐related cirrhosis
Author(s) -
Ma Hui,
Wei Lai,
Guo Fang,
Zhu Sainan,
Sun Yan,
Wang Hao
Publication year - 2008
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2008.05499.x
Subject(s) - medicine , cirrhosis , hbeag , gastroenterology , hepatitis b virus , survival analysis , hepatitis b , proportional hazards model , hbsag , immunology , virus
Aim: To compare the clinical features of hepatitis B e antigen (HBeAg)‐negative and HBeAg‐positive cirrhosis, and to define the survival and prognostic indicators of Chinese HBeAg‐negative hepatitis B virus (HBV)‐related cirrhosis. Methods: Two hundred and seventeen patients with chronic hepatitis B cirrhosis were studied. Survival was calculated using the Kaplan–Meier method. Proportional hazards Cox regression procedure was used to identify independent predictors of survival. The relationship between HBV‐DNA viral load and prognosis was also investigated. Results: The mean follow‐up time was 35 months (3–47 months). HBeAg‐negative liver cirrhosis patients comprised the greatest number of cirrhosis patients. Median alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, median total leukocytes (WBC), hemoglobin (Hb), platelet (Plt) and HBV‐DNA levels and the proportion of HBV‐DNA > 10 5 copies/mL were lower in HBeAg‐negative patients. There were fewer complications in patients treated with lamivudine than in other patients. Survival rates were significantly reduced in patients with HBeAg‐negative cirrhosis ( P = 0.0024). The baseline Child–Pugh scores and more than one decompensation during follow up were independent variables correlated with survival of HBeAg‐negative liver cirrhosis patients ( P = 0.006 and P = 0.001, respectively). The HBV‐DNA viral load did not correlate with any complications or mortality rates of HBeAg‐negative patients. Conclusions: The clinical features of HBeAg‐negative and ‐positive liver cirrhosis differ. Survival was significantly reduced for Chinese patients with HBeAg‐negative than ‐positive cirrhosis. Factors contributing to the prognosis were baseline Child–Pugh scores and the presence of more than one decompensation during follow up.