长期随访的HBsAg阳性患者在德国

StephenW

    European Journal of Gastroenterology & Hepatology:   
    January 2016 - Volume 28 - Issue 1 - p 48–56
            doi: 10.1097/MEG.0000000000000487
    Original Articles: Metabolic Liver Disease
  
  Long-term follow-up of HBsAg-positive patients in Germany      

Niederau, Clausa; Amani, Asefa; Thiel, Andreasb

              
   
   
  
      [url=][/url]Abstract      
   
         

Background: Little is known about the prognosis and complications of chronic hepatitis B in countries with low disease prevalence including Germany.

      

Materials and methods: This retrospective/prospective study analyzes the course of 608 HBsAg-positive patients between 2002 and 2012 in Germany. The follow-up duration was 5.2±2.9 years (mean±SD) and the age of the patients was 40.4±13.8 years. Of the total cohort, 59.9% were men; 34.9% had been born in Germany, 30.4% in Turkey, and 34.7% in other countries.

      

Results: In 78.3% of women, diagnosis was made during pregnancy screening, which is the only reinforced screening procedure in Germany. During follow-up, 21 patients died, five had a LTX, and 20 developed a hepatocellular carcinoma. Of the total cohort, 15% developed at least one severe liver-associated complication. By multivariate analysis, prognosis was associated with high age and cirrhosis, but not with sex, HBV-DNA, alanine aminotransferase, and ethnic origin. Of the 608 patients, 211 (34.7%) had at least one antiviral therapy. Of the 178 patients who were treated with nucleot(s)ides at the last visit 88.8% had an HBV-DNA less than 20 IU/ml.

      

Conclusion: Today, in Germany, hepatitis B is a disease of migrants. The present data show that mandatory screening is effective and needs to include more high-risk groups. Mortality and complications including hepatocellular carcinoma are associated primarily with cirrhosis and age, but not with HBeAg status or viral load probably because modern therapies considerably reduce viral replication in almost all patients. The prognosis is exclusively determined by the risk for hepatocellular carcinoma.

   
  

StephenW

欧洲胃肠病学和肝病学：
2016年1月 - 28卷 - 第1期 - P 48-56
DOI：10.1097 / MEG.0000000000000487
原创文章：代谢性肝病
长期随访的HBsAg阳性患者在德国

Niederau的，Clausa;阿曼尼，ASEFA;泰尔，Andreasb
折叠盒
抽象

背景：鲜为人知的是，在低疾病流行，包括德国国家预后和治疗慢性乙型肝炎的并发症。

材料与方法：回顾性/前瞻性研究分析了德国的608 HBsAg阳性患者2002年至2012年期间。随访时间为5.2±2.9岁，平均（±SD）和患者的年龄为40.4±13.8年。总的队列中，59.9％为男性; 34.9％的人是出生在德国，土耳其30.4％，而在其他国家的34.7％。

结果：在妇女的78.3％，诊断是在怀孕期间筛选，这是德国唯一增强筛选程序进行。在随访期间，21名患者死亡，五有LTX和20制定了肝癌。总的队列中，15％的开发至少有一个严重的肝脏相关的并发症。多因素分析，预后具有较高的年龄和肝硬化有关，而与性别，HBV-DNA，丙氨酸氨基转移酶，以及民族血统。在608名患者中，211（34.7％）至少有一个抗病毒治疗。谁是在上次访问治疗nucleot（S）IDE中的178例患者中88.8％有一个HBV-DNA小于20 IU /毫升。

结论：今天，在德国，乙肝是流动人口的疾病。目前的数据表明，强制性筛查是有效的，需要包括更多的高危人群。死亡率和并发症，包括肝细胞癌主要与肝硬化及年龄相关，但不与HBeAg状态或病毒载量可能是因为现代疗法显着地降低病毒复制在几乎所有患者。预后是专门通过为肝癌的风险来确定。