进展为肝硬化，肝细胞癌和肝相关 死亡率在慢性乙型肝炎患

StephenW

http://www.dldjournalonline.com/article/S1590-8658(14)00025-5/abstract?rss=yes
Digestive and Liver Disease

Article in Press
Progression to cirrhosis, hepatocellular carcinoma and liver-related
mortality in chronic hepatitis B patients in Italy

Donatella Ieluzzi, Loredana Covolo, Francesco Donato, Giovanna Fattovich

Corresponding Author Information
email address
Received 11 July 2013; accepted 10 January 2014. published online 18
February 2014.

Abstract
Background
The natural history of chronic hepatitis B is variable. We evaluated some
of the risk factors for cirrhosis, hepatocellular carcinoma and
liver-related mortality in Italian patients with chronic hepatitis B.
Methods A cohort of 105 untreated patients with chronic hepatitis B without
cirrhosis at diagnosis was followed prospectively for a mean period of 23
years. Clinical, histological and ultrasound examinations, biochemical and
virological tests, and causes of death were analyzed. Results Forty-two
(40%) patients became inactive carriers and 63 (60%) showed persistent
alanine aminotransferase elevation: 13 (13%) associated with HBeAg
persistence, 35 (33%) with detectable serum HBV-DNA but HBeAg-negative, 11
(10%) with concurrent virus infection and 4 (4%) with non-alcoholic fatty
liver disease. Cirrhosis incidence was 1.56/100 person-years. Older age and
sustained HBV replication predicted cirrhosis occurrence independently.
Hepatocellular carcinoma incidence was 2.1/100 person-years in patients who
developed cirrhosis and 0.06 in those who did not. Cirrhosis occurrence
was associated with an increased risk of hepatocellular carcinoma (hazard
ratio 20.4, 95% confidence interval 2.54–167.5) and liver-related death
(16.5, 2.0–138.8). Conclusions In Italian patients with chronic hepatitis
B cirrhosis strongly predicts hepatocellular carcinoma occurrence and
disease-related mortality, thus indicating that early antiviral treatment
should be instituted before cirrhosis occurrence.

StephenW

http://www.dldjournalonline.com/article/S1590-8658 （ 14 ） 00025-5/abstract ？ RSS =是
消化系统和肝脏疾病

文章新闻
进展为肝硬化，肝细胞癌和肝相关
死亡率在慢性乙型肝炎患者在意大利

多纳泰拉Ieluzzi ， Loredana的Covolo ，弗朗切斯科多纳托，乔凡娜Fattovich

通讯作者信息
电子邮件地址
收到2013年7月11日，接受2014年1月10日。网上公布的18
2014年2月。

摘要
背景
慢性乙肝的自然病程是可变的。我们评估了一些
的危险因素，肝硬化，肝细胞癌和
在意大利慢性乙型肝炎肝相关死亡率
方法105例未经治疗的慢性乙型肝炎的队列不
肝硬化的诊断是前瞻性随访了23的平均周期
年。临床，病理及超声检查，生化和
病毒学测试，和死亡原因进行了分析。结果43个
（ 40 ％）患者成为非活动性携带者和63 （ 60 ％ ）表现为持续性
谷丙转氨酶升高： 13 （ 13 ％ ）与HBeAg的相关
持久性， 35 （ 33 ％ ）可检测到血清HBV - DNA，但HBeAg阴性， 11
（ 10％），并发病毒感染和4 （4％ ）与非酒精性脂肪
肝脏疾病。肝硬化发生率为1.56/100人年。年龄较大，
持续HBV复制预测肝硬化发生独立。
肝癌发病率为2.1/100人 - 年的病人谁
发达的肝硬化和那些谁没有0.06 。肝硬化的发生
是与肝细胞癌的风险增加（风险相关
比20.4 ， 95 ％可信区间2.54-167.5 ）和肝相关死亡
（ 16.5 ， 2.0-138.8 ） 。结论在意大利慢性肝炎患者
后肝硬化强烈地预测肝癌发生和
疾病相关的死亡率，从而表明早期抗病毒治疗
肝硬化发生之前，应提起。