Predicting cirrhosis risk based on the level of circulating hepatitis B viral load
Predicting cirrhosis risk based on the level of circulating hepatitis B viral load
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DOI：
10.1053/j.gastro.2005.11.016
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发表时间：
2006-03-01
期刊：
影响因子：
29.4
通讯作者：
Chen, CJ
中科院分区：
文献类型：
--
作者：
Iloeje, UH;Yang, HI;Chen, CJ
背景与目的：肝硬化是慢性B型肝炎感染后肝脏炎症和纤维化的结果。我们报告了慢性B肝炎病毒血症与肝硬化进展之间的关系。方法：这是一项基于人群的前瞻性队列研究，研究对象为1991年至1992年在台湾建立的3582例未经治疗的乙型肝炎感染患者。对入组血清样本进行HBV DNA检测，并通过超声诊断肝硬化。结果如下：在1：1的平均随访时间内，3582例患者进行了40,038人年的随访评价，365例患者新诊断为肝硬化。肝硬化的累积发生率随着HBV-DNA水平的升高而增加，对于B型肝炎病毒载量低于300拷贝/mL和106拷贝/mL或更高的患者，肝硬化的累积发生率分别为4.5%至36.2%（P分别= 10（4）- = 10（5）- = 10（6）拷贝/mL）。结论：这些数据表明，乙型肝炎感染者肝硬化的进展与循环病毒的水平密切相关。肝硬化的风险随着HBV-DNA水平的增加而显著增加，并且与B e抗原状态和血清丙氨酸转氨酶水平无关。
Background & Aims: Cirrhosis develops as a result of hepatic inflammation and subsequent fibrosis in chronic hepatitis B infection. We report on the relationship between hepatitis B viremia and progression to cirrhosis in chronic hepatitis B infection. Methods: This was a population-based prospective cohort study of 3582 untreated hepatitis B-infected patients established in Taiwan from 1991 to 1992. Serum samples were tested for HBV DNA on cohort entry serum samples and the diagnosis of cirrhosis was by ultrasound. Results: During a mean follow-up time of 1:1 years, the 3582 patients contributed 40,038 person-years of follow-up evaluation and 365 patients were newly diagnosed with cirrhosis. The cumulative incidence of cirrhosis increased with the HBV-DNA level and ranged from 4.5% to 36.2% for patients with a hepatitis B viral load of less than 300 copies/mL and 106 copies/mL or more, respectively (P = 10(4) - = 10(5) - = 10(6) copies/mL, respectively. Conclusions: These data show that progression to cirrhosis in hepatitis B-infected persons is correlated strongly with the level of circulating virus. The risk for cirrhosis increases significantly with increasing HBV-DNA levels and is independent of hepatitis B e-antigen status and serum alanine transaminase level.