Chronic infection with hepatitis B virus is a risk factor for cirrhosis and hepatocellular carcinoma.
However, predictors of disease outcome are poorly defined.
Dr Raffaella Romeo and colleagues from Italy tracked the course of the hepatitis B virus infection in 299 patients over a mean period of 233 months.
The team analyzed data from patients who had been hepatitis B virus positive for at least 6 months admitted from 1978 to 2006 to Maggiore Hospital, Milan.
|The main cause of death was liver failure|
Hepatitis B virus infection was defined by the presence of hepatitis B virus antigen in liver tissue or serum hepatitis B virus RNA in anti-hepatitis virus/hepititis B surface antigen seropositive patients.
At enrollment, 7 patients had acute hepatitis, 101 had mild-moderate chronic hepatitis, 76 had severe chronic hepatitis, and 104 had histologic or clinical cirrhosis.
The team reported that 90 patients were treated with interferon, 62 with corticosteroids, and 12 with nucleoside analogues, and 135 received no therapy.
The researchers found over a mean period of 233 months, 82 patients developed cirrhosis.
Among the 186 total patients with cirrhosis, 46 developed hepatocellular carcinoma, 43 ascites, 44 jaundice, and 1 encephalopathy.
Female sex, alcohol abuse, and hepatitis virus replication were associated with liver decompensation, Hepatitis B replication and interferon were associated with hepatocellular carcinoma development.
By the end of the study, 186 patients were still alive, 63 had died, and 29 had received liver transplants.
The team noted that the main cause of death was liver failure.
The research team found that the hepatitis B virus replication was the only independent predictor of mortality.
Dr Romeo's team concluded, “Persistent hepatitis B virus replication leads to cirrhosis and Hepatocellular carcinoma at annual rates of 4% and 3%, respectively, and is the only predictor of liver-related mortality."