Document Detail

Prevalence of fibrosis and cirrhosis in chronic hepatitis B: implications for treatment and management.
MedLine Citation:
PMID:  18422821     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To document the prevalence and factors associated with severe fibrosis and cirrhosis in a large population of Asian chronic hepatitis B (CHB) patients. METHODS: Transient elastography was performed in unselected CHB patients. Liver stiffness score of <8.1 kPa was used as a cut-off for the presence of severe fibrosis or liver cirrhosis. RESULTS: 1315 patients were recruited, of which 951 (72%) were treatment-naive. Of these, 319 (34%) had severe fibrosis, with higher prevalence seen in males compared with females (39% vs 24% respectively, p < 0.01. Severe fibrosis was seen with increasing age from 20% in patients <25 years to 81% in those >65 years. Higher prevalence of severe fibrosis was seen in HBeAg(+) patients compared to HBeAg(-) patients age >45 years (58% vs 43% respectively, p = 0.03), in patients with HBV DNA levels >or=4 log compared with <4 log copies/ml (41% vs 27% respectively, p < 0.01), and in patients with stepwise increase of ALT levels (<0.5 x ULN vs 0.5-1 x ULN vs 1-2 x ULN; 11% vs 30% vs 48% respectively, p < 0.01). After multivariate analysis, gender, age and ALT levels were significant factors associated with severe fibrosis. Patients who received antiviral treatment had lower ALT, stiffness score and prevalence of cirrhosis compared to treatment-naive patients [25 vs 35 U/L (p < 0.01), 6.2 vs 6.7 kPa (p = 0.031) and 14% vs 22% (p = 0.008) respectively]. CONCLUSION: The overall prevalence of severe fibrosis in CHB patients was 34% with higher rates seen in older age groups, males, and in patients with higher ALT levels.
James Fung; Ching-Lung Lai; David But; Danny Wong; Ting-Kin Cheung; Man-Fung Yuen
Publication Detail:
Type:  Journal Article     Date:  2008-04-16
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  103     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-12     Completed Date:  2008-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1421-6     Citation Subset:  IM    
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
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MeSH Terms
Age Distribution
Aged, 80 and over
Antiviral Agents / therapeutic use*
Asian Continental Ancestry Group / statistics & numerical data*
Cohort Studies
Elasticity Imaging Techniques
Hepatitis B, Chronic / complications*,  drug therapy,  ethnology*
Hong Kong / epidemiology
Liver Cirrhosis / diagnosis,  epidemiology*,  virology*
Middle Aged
Risk Factors
Sex Distribution
Reg. No./Substance:
0/Antiviral Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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