Non-invasive tests for fibrosis and liver stiffness predict 5-year survival of patients chronically infected with hepatitis B virus
Non-invasive tests for fibrosis and liver stiffness predict 5-year survival of patients chronically infected with hepatitis B virus
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DOI：
10.1111/apt.12307
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发表时间：
2013-05-01
影响因子：
7.6
通讯作者：
Bernard, P. -H.
中科院分区：
文献类型：
--
作者：
de Ledinghen, V.;Vergniol, J.;Bernard, P. -H.
背景：肝硬度和非侵入性检测可预测慢性丙型肝炎患者的总生存率。然而，在慢性感染B型肝炎病毒（HBV）的患者中，仅发表了肝硬度与肝细胞癌风险之间的相关性。目的评价肝硬度、无创性肝纤维化检查和肝活检对慢性B型肝炎患者5年预后的价值，以预测总生存率。方法在一个连续的队列中，我们前瞻性地评估了肝纤维化，包括肝硬度、FibroTest、APRI、FIB-4和肝活检（如有指征）。我们研究了5年随访期间的死亡和肝移植，以及与总生存率相关的因素。结果共纳入600例慢性B型肝炎患者，男性64%，平均年龄42岁，非活动性携带者36%。5年时，25例患者死亡（13例肝脏相关死亡），4例患者接受了肝移植。总生存率为94.1%，无肝脏相关死亡的生存率为96.3%。在非活动携带者中未观察到与肝脏相关的死亡。无论采用何种非侵入性方法，诊断为严重纤维化的患者生存率显著降低（P
Background Liver stiffness and non-invasive tests predict overall survival in chronic hepatitis C. However, in patients chronically infected with hepatitis B virus (HBV), only the association between liver stiffness and the risk of hepatocellular carcinoma has been published. Aim To evaluate the 5-year prognostic value of liver stiffness, non-invasive tests of liver fibrosis, and liver biopsy, to predict overall survival in chronic hepatitis B. Methods In a consecutive cohort, we prospectively assessed fibrosis, with liver stiffness, FibroTest, APRI, FIB-4 and liver biopsy (if indicated). We examined death and liver transplantation during a 5-year follow-up, and factors associated with overall survival. Results A total of 600 patients (men 64%, mean age 42 years, inactive carriers 36%) with chronic hepatitis B were included. At 5 years, 25 patients were dead (13 liver-related deaths) and four patients had liver transplantation. Overall survival was 94.1% and survival without liver-related death 96.3%. No liver-related death was observed in inactive carriers. Survival was significantly decreased in patients diagnosed with severe fibrosis, whatever the non-invasive method used (P