Different natural courses of chronic hepatitis B with genotypes B and C after the fourth decade of life

World J Gastroenterol. 2007 Sep 14;13(34):4560-5. doi: 10.3748/wjg.v13.i34.4560.

Abstract

Aim: To investigate the different impact of genotypes B and C on the development of liver cirrhosis (LC) among different age groups of patients with chronic hepatitis B (CH-B).

Methods: We examined the outcome of 121 patients with CH-B, divided by age and genotype. Univariate analyses were used to compare different groups. The Cox proportional hazard model was employed to evaluate factors affecting the development of LC.

Results: In patients < 30 years old, there were no significant predictors for development of LC. However, in patients > or = 30 years old, genotype C was the only significant predictor. In the genotype C group, 8 of 12 patients who progressed to LC were 30-49 years old at initial diagnosis of chronic hepatitis (7 patients were positive for HBeAg). In the genotype B group, 4 of 8 patients who developed LC were > or = 50 years old at initial diagnosis and were HBeAg-negative.

Conclusion: The rate of development of LC was comparable in patients infected with genotypes B and C when CH-B occurred at < 30 years old. However, CH-B patients infected with genotype C showed poor prognosis if they were 30-49 years old and were positive for HBeAg. Age-specific natural course of CH-B should be considered when patients with CH-B are treated with antiviral drugs.

MeSH terms

  • Adult
  • Age Distribution
  • Age Factors
  • Aged
  • Aging*
  • DNA, Viral*
  • Disease Progression
  • Genotype
  • Hepatitis B e Antigens / blood
  • Hepatitis B virus / genetics*
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / diagnosis
  • Hepatitis B, Chronic / genetics
  • Hepatitis B, Chronic / immunology
  • Humans
  • Kaplan-Meier Estimate
  • Liver Cirrhosis / virology*
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index

Substances

  • DNA, Viral
  • Hepatitis B e Antigens