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Effect of hepatitis B and C virus infections on the natural history of compensated cirrhosis: a cohort study of 297 patients.
Am J Gastroenterol 2002; 97(11):2886-95AJ

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.

Authors+Show Affiliations

Servizio Autonomo Clinicizzato di Gastroenterologia, University of Verona, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12425564

Citation

Fattovich, Giovanna, et al. "Effect of Hepatitis B and C Virus Infections On the Natural History of Compensated Cirrhosis: a Cohort Study of 297 Patients." The American Journal of Gastroenterology, vol. 97, no. 11, 2002, pp. 2886-95.
Fattovich G, Pantalena M, Zagni I, et al. Effect of hepatitis B and C virus infections on the natural history of compensated cirrhosis: a cohort study of 297 patients. Am J Gastroenterol. 2002;97(11):2886-95.
Fattovich, G., Pantalena, M., Zagni, I., Realdi, G., Schalm, S. W., & Christensen, E. (2002). Effect of hepatitis B and C virus infections on the natural history of compensated cirrhosis: a cohort study of 297 patients. The American Journal of Gastroenterology, 97(11), pp. 2886-95.
Fattovich G, et al. Effect of Hepatitis B and C Virus Infections On the Natural History of Compensated Cirrhosis: a Cohort Study of 297 Patients. Am J Gastroenterol. 2002;97(11):2886-95. PubMed PMID: 12425564.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of hepatitis B and C virus infections on the natural history of compensated cirrhosis: a cohort study of 297 patients. AU - Fattovich,Giovanna, AU - Pantalena,Maurizio, AU - Zagni,Irene, AU - Realdi,Giuseppe, AU - Schalm,Solko W, AU - Christensen,Erik, AU - ,, PY - 2002/11/12/pubmed PY - 2002/11/26/medline PY - 2002/11/12/entrez SP - 2886 EP - 95 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 97 IS - 11 N2 - 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. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/12425564/Effect_of_hepatitis_B_and_C_virus_infections_on_the_natural_history_of_compensated_cirrhosis:_a_cohort_study_of_297_patients_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0002-9270&date=2002&volume=97&issue=11&spage=2886 DB - PRIME DP - Unbound Medicine ER -