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Article: Prevalence of fibrosis and cirrhosis in chronic hepatitis B: Implications for treatment and management

TitlePrevalence of fibrosis and cirrhosis in chronic hepatitis B: Implications for treatment and management
Authors
Issue Date2008
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
Citation
American Journal Of Gastroenterology, 2008, v. 103 n. 6, p. 1421-1426 How to Cite?
AbstractOBJECTIVE: To document the prevalence and factors associated with severe fibrosis and cirrhosis in a large population of Asian chronic hepatitis B (CHB) patients. METHODS: Transient elastography was performed in unselected CHB patients. Liver stiffness score of <8.1 kPa was used as a cut-off for the presence of severe fibrosis or liver cirrhosis. RESULTS: 1315 patients were recruited, of which 951 (72%) were treatment-naïve. Of these, 319 (34%) had severe fibrosis, with higher prevalence seen in males compared with females (39% vs 24% respectively, p < 0.01. Severe fibrosis was seen with increasing age from 20% in patients <25 years to 81% in those >65 years. Higher prevalence of severe fibrosis was seen in HBeAg(+) patients compared to HBeAg(-) patients age >45 years (58% vs 43% respectively, p = 0.03), in patients with HBV DNA levels ≥4 log compared with <4 log copies/ml (41% vs 27% respectively, p < 0.01), and in patients with stepwise increase of ALT levels (<0.5 × ULN vs 0.5-1 × ULN vs 1-2 × ULN; 11% vs 30% vs 48% respectively, p < 0.01). After multivariate analysis, gender, age and ALT levels were significant factors associated with severe fibrosis. Patients who received antiviral treatment had lower ALT, stiffness score and prevalence of cirrhosis compared to treatment-naïve patients [25 vs 35 U/L (p < 0.01), 6.2 vs 6.7 kPa (p = 0.031) and 14% vs 22% (p = 0.008) respectively]. CONCLUSION: The overall prevalence of severe fibrosis in CHB patients was 34% with higher rates seen in older age groups, males, and in patients with higher ALT levels. © 2008 by Am. Coll. of Gastroenterology.
Persistent Identifierhttp://hdl.handle.net/10722/59339
ISSN
2015 Impact Factor: 10.383
2015 SCImago Journal Rankings: 3.946
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorFung, Jen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorBut, Den_HK
dc.contributor.authorWong, Den_HK
dc.contributor.authorCheung, TKen_HK
dc.contributor.authorYuen, MFen_HK
dc.date.accessioned2010-05-31T03:48:01Z-
dc.date.available2010-05-31T03:48:01Z-
dc.date.issued2008en_HK
dc.identifier.citationAmerican Journal Of Gastroenterology, 2008, v. 103 n. 6, p. 1421-1426en_HK
dc.identifier.issn0002-9270en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59339-
dc.description.abstractOBJECTIVE: To document the prevalence and factors associated with severe fibrosis and cirrhosis in a large population of Asian chronic hepatitis B (CHB) patients. METHODS: Transient elastography was performed in unselected CHB patients. Liver stiffness score of <8.1 kPa was used as a cut-off for the presence of severe fibrosis or liver cirrhosis. RESULTS: 1315 patients were recruited, of which 951 (72%) were treatment-naïve. Of these, 319 (34%) had severe fibrosis, with higher prevalence seen in males compared with females (39% vs 24% respectively, p < 0.01. Severe fibrosis was seen with increasing age from 20% in patients <25 years to 81% in those >65 years. Higher prevalence of severe fibrosis was seen in HBeAg(+) patients compared to HBeAg(-) patients age >45 years (58% vs 43% respectively, p = 0.03), in patients with HBV DNA levels ≥4 log compared with <4 log copies/ml (41% vs 27% respectively, p < 0.01), and in patients with stepwise increase of ALT levels (<0.5 × ULN vs 0.5-1 × ULN vs 1-2 × ULN; 11% vs 30% vs 48% respectively, p < 0.01). After multivariate analysis, gender, age and ALT levels were significant factors associated with severe fibrosis. Patients who received antiviral treatment had lower ALT, stiffness score and prevalence of cirrhosis compared to treatment-naïve patients [25 vs 35 U/L (p < 0.01), 6.2 vs 6.7 kPa (p = 0.031) and 14% vs 22% (p = 0.008) respectively]. CONCLUSION: The overall prevalence of severe fibrosis in CHB patients was 34% with higher rates seen in older age groups, males, and in patients with higher ALT levels. © 2008 by Am. Coll. of Gastroenterology.en_HK
dc.languageengen_HK
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.htmlen_HK
dc.relation.ispartofAmerican Journal of Gastroenterologyen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAge Distributionen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAntiviral Agents - therapeutic useen_HK
dc.subject.meshAsian Continental Ancestry Group - statistics & numerical dataen_HK
dc.subject.meshCohort Studiesen_HK
dc.subject.meshElasticity Imaging Techniquesen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHepatitis B, Chronic - complications - drug therapy - ethnologyen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLiver Cirrhosis - diagnosis - epidemiology - virologyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPrevalenceen_HK
dc.subject.meshRisk Factorsen_HK
dc.subject.meshSex Distributionen_HK
dc.titlePrevalence of fibrosis and cirrhosis in chronic hepatitis B: Implications for treatment and managementen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0002-9270&volume=103&issue=6&spage=1421&epage=26&date=2008&atitle=Prevalence+of+fibrosis+and+cirrhosis+in+chronic+hepatitis+B:+Implications+for+treatment+and+management.++en_HK
dc.identifier.emailFung, J:jfung@sicklehut.comen_HK
dc.identifier.emailLai, CL:hrmelcl@hku.hken_HK
dc.identifier.emailWong, D:danywong@hku.hken_HK
dc.identifier.emailYuen, MF:mfyuen@hkucc.hku.hken_HK
dc.identifier.authorityFung, J=rp00518en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authorityWong, D=rp00492en_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1572-0241.2007.01751.xen_HK
dc.identifier.pmid18422821-
dc.identifier.scopuseid_2-s2.0-44949096255en_HK
dc.identifier.hkuros161080en_HK
dc.identifier.hkuros144473-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-44949096255&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume103en_HK
dc.identifier.issue6en_HK
dc.identifier.spage1421en_HK
dc.identifier.epage1426en_HK
dc.identifier.isiWOS:000256610700020-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridFung, J=23091109300en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK
dc.identifier.scopusauthoridBut, D=24343113400en_HK
dc.identifier.scopusauthoridWong, D=7401535819en_HK
dc.identifier.scopusauthoridCheung, TK=7103334158en_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK
dc.identifier.citeulike2886300-

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