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Published on: December 15, 2023
Clinical features and survival in Chinese patients with hepatitis B e antigen-negative hepatitis B virus-related
1Peking University Hepatology Institute, Peking University People's Hospital, Beijing, China.
Insights
Hepatitis B e antigen (HBeAg)-negative cirrhosis in Chinese patients shows reduced survival compared to HBeAg-positive cases. Prognosis is linked to baseline Child-Pugh scores and decompensation frequency.
Area of Science:
- Hepatology
- Virology
- Clinical Medicine
Background:
- Chronic hepatitis B virus (HBV) infection can lead to liver cirrhosis.
- Hepatitis B e antigen (HBeAg) status is a key factor in HBV infection.
- Understanding differences between HBeAg-negative and HBeAg-positive cirrhosis is crucial for patient management.
Purpose of the Study:
- To compare clinical features of HBeAg-negative and HBeAg-positive cirrhosis.
- To identify survival and prognostic indicators in Chinese patients with HBeAg-negative HBV-related cirrhosis.
Main Methods:
- Study included 217 patients with chronic hepatitis B cirrhosis.
- Kaplan-Meier method for survival analysis.
- Cox regression to identify independent predictors of survival; HBV-DNA viral load was investigated.
Main Results:
- HBeAg-negative cirrhosis patients had lower ALT, AST, WBC, Hb, Plt, and HBV-DNA levels.
- Survival rates were significantly reduced in HBeAg-negative cirrhosis patients (P = 0.0024).
- Baseline Child-Pugh scores and multiple decompensations independently predicted survival in HBeAg-negative cirrhosis.
Conclusions:
- Clinical features and survival differ between HBeAg-negative and HBeAg-positive liver cirrhosis.
- HBeAg-negative cirrhosis in Chinese patients is associated with significantly reduced survival.
- Baseline Child-Pugh score and frequency of decompensation are key prognostic factors.
Aim:
To compare the clinical features of hepatitis B e antigen (HBeAg)-negative and HBeAg-positive cirrhosis, and to define the survival and prognostic indicators of Chinese HBeAg-negative hepatitis B virus (HBV)-related cirrhosis.
Methods:
Two hundred and seventeen patients with chronic hepatitis B cirrhosis were studied. Survival was calculated using the Kaplan-Meier method. Proportional hazards Cox regression procedure was used to identify independent predictors of survival. The relationship between HBV-DNA viral load and prognosis was also investigated.
Results:
The mean follow-up time was 35 months (3-47 months). HBeAg-negative liver cirrhosis patients comprised the greatest number of cirrhosis patients. Median alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, median total leukocytes (WBC), hemoglobin (Hb), platelet (Plt) and HBV-DNA levels and the proportion of HBV-DNA > 10(5) copies/mL were lower in HBeAg-negative patients. There were fewer complications in patients treated with lamivudine than in other patients. Survival rates were significantly reduced in patients with HBeAg-negative cirrhosis (P = 0.0024). The baseline Child-Pugh scores and more than one decompensation during follow up were independent variables correlated with survival of HBeAg-negative liver cirrhosis patients (P = 0.006 and P = 0.001, respectively). The HBV-DNA viral load did not correlate with any complications or mortality rates of HBeAg-negative patients.
Conclusions:
The clinical features of HBeAg-negative and -positive liver cirrhosis differ. Survival was significantly reduced for Chinese patients with HBeAg-negative than -positive cirrhosis. Factors contributing to the prognosis were baseline Child-Pugh scores and the presence of more than one decompensation during follow up.
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