Past HBV viral load as predictor of mortality and morbidity from HCC and chronic liver disease in a prospective study
Past HBV viral load as predictor of mortality and morbidity from HCC and chronic liver disease in a prospective study
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一项前瞻性研究中过去的 HBV 病毒载量作为 HCC 和慢性肝病死亡率和发病率的预测因子
DOI：
10.1111/j.1572-0241.2006.00647.x
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发表时间：
2006-08-01
影响因子：
9.8
通讯作者：
Evans, Alison A.
中科院分区：
文献类型：
--
作者：
Chen, Gang;Lin, Wenyao;Evans, Alison A.
背景和目标：在一项随访11年的前瞻性队列研究中，我们评估了既往B型肝炎病毒（HBV）载量与死亡率之间的关系。存活的队列成员进行评估，为当前liverdiseases.METHODS：我们测量HBV病毒载量的实时聚合酶链反应储存的样本从队列进入（1992-1993年）在2,763年肝炎B表面抗原（HBsAg）阳性的成年人。主要终点为肝细胞癌（HCC）或慢性肝病（CLD）死亡。死亡447人。在1,683名幸存者中，我们在2003年回访时评估了肝病的严重程度。病毒载量分为三类：未检出（< 1.6 x 10（3）拷贝/mL）;低滴度（< 10（5）拷贝/mL）;和高滴度（>= 10（5）拷贝/mL）。对于HCC，与HBV未检测类别相比，病毒载量类别的死亡率显著增加（p（趋势）< 0.001），低病毒载量组HCC死亡的相对危险度（RR）为1.7（95%可信区间[CI] 0.5-5.7），高病毒载量组为11.2（3.6-35.0）。对于CLD死亡率，RR分别为1.5（0.2-12.1）和15.2（2.1-109.8），p（趋势）< 0.001）。与高病毒载量相关的RR并不随随访时间的延长而改变。在2003年评估的存活队列成员的肝脏疾病，也有一个显着的相关性病毒载量与疾病severity.CONCLUSION：在这项前瞻性研究中，病毒载量与HBV感染的受试者肝癌和慢性肝病的死亡率增加。病毒载量可能是HBV感染的一个有用的预后工具，应探讨旨在降低病毒载量的干预措施。
BACKGROUND AND AIMS: In a prospective cohort study with 11 yr of follow-up, we assessed the relationship between past hepatitis B virus (HBV) viral load and mortality. Surviving cohort members were evaluated for current liver disease.METHODS: We measured HBV viral load by real-time polymerase chain reaction on stored samples from cohort entry (1992-1993) in 2,763 hepatitis B surface antigen (HBsAg)-positive adults. Major end points were death from hepatocellular carcinoma (HCC) or chronic liver disease (CLD). There were 447 deaths. In the 1,683 survivors, we assessed severity of liver disease on a return visit in 2003. Viral load was divided into three categories: undetected (< 1.6 x 10(3) copies/mL); low titer (< 10(5) copies/mL); and high titer (>= 10(5) copies/mL).RESULTS: For HCC, there was a significant increase in mortality across viral load categories (p(trend) < 0.001)Compared to the HBV undetected category, the relative risk (RR) for HCC mortality in the low viral load group was 1.7 (95% confidence interval [CI] 0.5-5.7) and 11.2 (3.6-35.0) in the high viral load group. For CLD mortality, the RRs were 1.5 (0.2-12.1) and 15.2 (2.1-109.8), respectively p(trend) < 0.001). The RR associated with high viral load did not change with increased follow-up time. In surviving cohort members evaluated for liver disease in 2003, there was also a significant association of viral load with disease severity.CONCLUSION: In this prospective study, viral load is associated with increased mortality from HCC and CLD in HBV-infected subjects. Viral load may be a useful prognostic tool in HBV infection, and interventions aimed at its reduction should be explored.