|
|
Learning Objectives for this Presentation:
By the end of this presentation participants should understand how the level of circulating virus can help predict patients at risk of disease progression in CHB.
Background:
Cirrhosis develops as a result of hepatic inflammation and subsequent fibrosis. Chronic hepatitis B (CHB) subjects are at increased risk of developing liver cirrhosis as ongoing viral replication is associated with hepatic inflammatory activity. This study examines if increasing levels of HBV DNA are associated with increasing risk of cirrhosis
Methods:
A cohort of 3,851 HBsAg-positive subjects was established from 7 townships in Taiwan between 1991 and 1992. Serum samples were tested for HBV DNA by PCR. Cirrhosis was diagnosed by ultrasonography. Cirrhosis incidence rate per person-year of follow-up (PYFU) for each HBV DNA strata was calculated. The multivariable adjusted relative risk (RRadj) was derived from Cox proportional hazard models
Results:
77 subjects were excluded (2 died within 6 months of enrolment, 75 diagnosed with cirrhosis) leaving 3,774 subjects. During 42,115 PYFU, 395 cirrhosis cases were newly diagnosed. Cirrhosis incidence rate ranged from 386.1/100,000 PYFU with HBV DNA <300 copies/mL to 2,575.7/100,000 PYFU with HBV DNA „d106 copies/mL (p<0.0001) in a dose-dependent manner. With <300 copies/mL as reference, and adjusting for gender, age, habits of cigarette smoking, alcohol consumption, and hepatitis C virus antibodies, the risk of cirrhosis began increasing at an HBV DNA level of 104 copies/mL with a RRadj of 2.2 (95% CI 1.5-3.3) and was 8.7 (95% CI 6.2-12.3) for those who had HBV DNA „d106 copies/mL
Conclusions:
HBV DNA level is a strong predictor of cirrhosis risk. The incidence of cirrhosis increases with HBV DNA level in a dose-dependent manner. Conversely, reducing HBV DNA level is likely to decrease cirrhosis risk in CHB patients
See more of Poster Session #1
See more of The 2005 National Viral Hepatitis Prevention Conference