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Article: Prognostic determinants for chronic hepatitis B in Asians: Therapeutic implications

TitlePrognostic determinants for chronic hepatitis B in Asians: Therapeutic implications
Authors
Issue Date2005
PublisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/
Citation
Gut, 2005, v. 54 n. 11, p. 1610-1614 How to Cite?
AbstractBackground: Identifying risk factors for the development of complications of chronic hepatitis B (CHB) is important for setting up treatment criteria. Aim: To determine risk factors for the development of complications in Asian CHB patients. Patients and methods: A total of 3233 Chinese CHB patients (mean follow up 46.8 months) were monitored for liver biochemistry, viral serology, hepatitis B virus (HBV) DNA levels, acute exacerbation, hepatitis B e antigen (HBeAg) seroconversion, and development of cirrhotic complications and hepatocellular carcinoma. Results: Median age for HBeAg seroconversion and development of complications was 35 years and 57.2 years, respectively. Patients with alanine aminotransferase (ALT) levels of 0.5-1 times the upper limit of normal (ULN) and 1-2 × ULN had an increased risk for the development of complications compared with patients with ALT levels <0.5 × ULN (p<0.0001 for both). HBeAg/antibody to hepatitis B e antigen status, and number of episodes, duration, and peak ALT levels of acute exacerbations were not associated with an increased risk of complications. In patients with complications, 43.6% had HBV DNA levels less than 1.42×105 copies/ml. Male sex, stigmata of chronic liver disease, old age, low albumin, and high a fetoprotein levels on presentation were independently associated with increased cumulative risk of complications. Male sex, presence of hepatitis symptoms, old age, low albumin level, and presence of complications on presentation were independently associated with shorter survival. Conclusion: Prolonged low level viraemia causing insidious and continual liver damage, as reflected by ALT levels of 0.5-2 × ULN, is the most likely pathway for the development of complications in Asian CHB patients.
Persistent Identifierhttp://hdl.handle.net/10722/43077
ISSN
2015 Impact Factor: 14.921
2015 SCImago Journal Rankings: 6.474
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYuen, MFen_HK
dc.contributor.authorYuan, HJen_HK
dc.contributor.authorWong, DKHen_HK
dc.contributor.authorYuen, JCHen_HK
dc.contributor.authorWong, WMen_HK
dc.contributor.authorChan, AOOen_HK
dc.contributor.authorWong, BCYen_HK
dc.contributor.authorLai, KCen_HK
dc.contributor.authorLai, CLen_HK
dc.date.accessioned2007-03-23T04:38:21Z-
dc.date.available2007-03-23T04:38:21Z-
dc.date.issued2005en_HK
dc.identifier.citationGut, 2005, v. 54 n. 11, p. 1610-1614en_HK
dc.identifier.issn0017-5749en_HK
dc.identifier.urihttp://hdl.handle.net/10722/43077-
dc.description.abstractBackground: Identifying risk factors for the development of complications of chronic hepatitis B (CHB) is important for setting up treatment criteria. Aim: To determine risk factors for the development of complications in Asian CHB patients. Patients and methods: A total of 3233 Chinese CHB patients (mean follow up 46.8 months) were monitored for liver biochemistry, viral serology, hepatitis B virus (HBV) DNA levels, acute exacerbation, hepatitis B e antigen (HBeAg) seroconversion, and development of cirrhotic complications and hepatocellular carcinoma. Results: Median age for HBeAg seroconversion and development of complications was 35 years and 57.2 years, respectively. Patients with alanine aminotransferase (ALT) levels of 0.5-1 times the upper limit of normal (ULN) and 1-2 × ULN had an increased risk for the development of complications compared with patients with ALT levels <0.5 × ULN (p<0.0001 for both). HBeAg/antibody to hepatitis B e antigen status, and number of episodes, duration, and peak ALT levels of acute exacerbations were not associated with an increased risk of complications. In patients with complications, 43.6% had HBV DNA levels less than 1.42×105 copies/ml. Male sex, stigmata of chronic liver disease, old age, low albumin, and high a fetoprotein levels on presentation were independently associated with increased cumulative risk of complications. Male sex, presence of hepatitis symptoms, old age, low albumin level, and presence of complications on presentation were independently associated with shorter survival. Conclusion: Prolonged low level viraemia causing insidious and continual liver damage, as reflected by ALT levels of 0.5-2 × ULN, is the most likely pathway for the development of complications in Asian CHB patients.en_HK
dc.format.extent103064 bytes-
dc.format.extent25600 bytes-
dc.format.extent53340 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypeapplication/msword-
dc.format.mimetypeapplication/pdf-
dc.languageengen_HK
dc.publisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/en_HK
dc.relation.ispartofGuten_HK
dc.rightsGut. Copyright © B M J Publishing Group.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAsian continental ancestry groupen_HK
dc.subject.meshHepatitis b, chronic - complications - ethnology - therapyen_HK
dc.subject.meshBiological markers - blooden_HK
dc.subject.meshViremia - complicationsen_HK
dc.subject.meshAlanine transaminase - blooden_HK
dc.titlePrognostic determinants for chronic hepatitis B in Asians: Therapeutic implicationsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0017-5749&volume=54&issue=11&spage=1610&epage=1614&date=2005&atitle=Prognostic+determinants+for+chronic+hepatitis+B+in+Asians:+therapeutic+implicationsen_HK
dc.identifier.emailYuen, MF:mfyuen@hkucc.hku.hken_HK
dc.identifier.emailWong, DKH:danywong@hku.hken_HK
dc.identifier.emailWong, BCY:bcywong@hku.hken_HK
dc.identifier.emailLai, CL:hrmelcl@hku.hken_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.identifier.authorityWong, DKH=rp00492en_HK
dc.identifier.authorityWong, BCY=rp00429en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1136/gut.2005.065136en_HK
dc.identifier.pmid15871997-
dc.identifier.pmcidPMC1774768-
dc.identifier.scopuseid_2-s2.0-27444441182en_HK
dc.identifier.hkuros101352-
dc.identifier.hkuros122242-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-27444441182&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume54en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1610en_HK
dc.identifier.epage1614en_HK
dc.identifier.isiWOS:000232581800023-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK
dc.identifier.scopusauthoridYuan, HJ=7402446707en_HK
dc.identifier.scopusauthoridWong, DKH=7401535819en_HK
dc.identifier.scopusauthoridYuen, JCH=7102620480en_HK
dc.identifier.scopusauthoridWong, WM=7403972413en_HK
dc.identifier.scopusauthoridChan, AOO=7403167965en_HK
dc.identifier.scopusauthoridWong, BCY=7402023340en_HK
dc.identifier.scopusauthoridLai, KC=7402135595en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK

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