Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study
Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study
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DOI：
10.1186/s12876-019-0993-1
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发表时间：
2019-05-15
影响因子：
2.4
通讯作者：
Johannessen, Asgeir
中科院分区：
文献类型：
--
作者：
Desalegn, Hailemichael;Aberra, Hanna;Johannessen, Asgeir
背景在撒哈拉以南非洲，慢性B型肝炎（CH B）的抗病毒治疗基本上是不可用的;因此，对非洲CH B患者开始治疗后的预后知之甚少。在这项研究中，我们的目的是评估死亡率的预测因素在撒哈拉以南African. MethodsTwo百和76 CHB患者谁开始与替诺福韦酯富马酸盐在埃塞俄比亚的公立医院之间的治疗2015年3月18日，2017年8月1日，在这项分析中包括在最大的CHB队列之一。患者随访至2017年10月1日，通过医院记录和与亲属的电话访谈确定死亡。失代偿性肝硬化定义为当前或过去的腹水证据，无论是通过临床检查或超声检查。考克斯比例风险模型被用来确定死亡率的独立预测因素。Results 35例（12.7%）在随访期间死亡，其中33人在招募失代偿期肝硬化。从治疗开始至死亡的中位持续时间为110天（四分位数间距26-276）。随访6、12和24个月时的估计生存率分别为90.3%、88.2%和86.3%。死亡率的独立预测因子是失代偿期肝硬化（校正的风险比[AHR] 23.68; 95%CI 3.23-173.48; p=0.002），体重指数
BackgroundAntiviral treatment for chronic hepatitis B (CHB) is largely unavailable in sub-Saharan Africa; hence, little is known about the prognosis after initiating treatment in African CHB patients. In this study we aimed to assess predictors of mortality in one of the largest CHB cohorts in sub-Saharan Africa.MethodsTwo-hundred-and-seventy-six CHB patients who started treatment with tenofovir disoproxil fumarate at a public hospital in Ethiopia between March 18, 2015, and August 1, 2017, were included in this analysis. Patients were followed up until October 1, 2017, and deaths were ascertained through hospital records and telephone interview with relatives. Decompensated cirrhosis was defined as current or past evidence of ascites, either by clinical examination or by ultrasonography. Cox proportional hazard models were used to identify independent predictors of mortality.ResultsThirty-five patients (12.7%) died during follow-up, 33 of whom had decompensated cirrhosis at recruitment. The median duration from start of treatment to death was 110days (interquartile range 26-276). The estimated survival was 90.3, 88.2 and 86.3% at 6, 12 and 24months of follow-up, respectively. Independent predictors of mortality were decompensated cirrhosis (adjusted hazard ratio [AHR] 23.68; 95% CI 3.23-173.48; p=0.002), body mass index