Observational studyThe Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases
Retrospective analysis of hepatitis B virus chronic infection in 247 patients: clinical stages, response to treatment and poor prognostic factors.
Observational study in The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Spontaneous loss of surface antigen among adults living with chronic hepatitis B virus infection: a systematic review and pooled meta-analyses.The lancet. Gastroenterology & hepatology · 2019Pooled it
- Article
- Hepatitis B in the Northwestern region of Sao Paulo State: genotypes and resistance mutations.Revista do Instituto de Medicina Tropical de Sao Paulo · 2021Article
- Studies on the serological markers for hepatitis B virus infection among type 2 diabetic patients.Journal of clinical laboratory analysis · 2021Article
- Comparative study on guidelines in determining HBV phases in Iranian patients.Gastroenterology and hepatology from bed to bench · 2019Article
- Risk factors of transmission and natural history of chronic hepatitis B infection in Iranian patients.Gastroenterology and hepatology from bed to bench · 2019Article
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7 authors.
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Abstract
backgroundChronic hepatitis B is a major cause of cirrhosis, and the natural history of the disease has several clinical stages that should be thoroughly understood for the implementation of proper treatment. Nonetheless, curing the disease with antiviral treatment remains a challenge.
aimsTo describe the clinical course, response to treatment, and poor prognostic factors in 247 hepatitis B virus chronic infection patients treated in a tertiary hospital in Brazil.
methodsThis was a retrospective and observational study, by analyzing the medical records of HBV infected patients between January 2000 and January 2015.
resultsMost patients were male (67.2%) and 74.1% were HBeAg negative. Approximately 41% had cirrhosis and 8.5% were hepatitis C virus coinfected. The viral load was negative after two years on lamivudine, entecavir and tenofovir in 86%, 90.6%, and 92.9% of the patients, respectively. The five-year resistance rates for lamivudine, adefovir, entecavir, and tenofovir were 57.5%, 51.8%, 1.9%, and 0%, respectively. The overall seroconversion rates were 31.2% for HBeAg and 9.4% for HBsAg. Hepatocellular carcinoma was diagnosed in 9.7% of patients, liver transplantation was performed in 9.7%, and overall mortality was 10.5%. Elevations of serum alanine aminotransferase (p=0.0059) and viral load (p<0.0001) were associated with progression to liver cirrhosis. High viral load was associated with progression to hepatocellular carcinoma (p<0.0001). Significant risk factors associated with death were elevated alanine aminotransferase (p=0.0039), liver cirrhosis (p<0.0001), high viral load (p=0.007), and hepatocellular carcinoma (p=0.0008). HBeAg positive status was not associated with worse outcomes, and treatment may have been largely responsible.
conclusionsElevations of viral load and serum alanine aminotransferase may select patients with worse prognosis, especially progression to cirrhosis and hepatocellular carcinoma, which were strongly association with death.
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