慢性乙型肝炎病毒感染患者的肝病长期自然史：使用马尔可

StephenW

Journal of Gastroenterology

November 2018, Volume 53, Issue 11, pp 1196–1205 | Cite as
Long-term natural history of liver disease in patients with chronic hepatitis B virus infection: an analysis using the Markov chain model

    Authors
    Authors and affiliations

    Toshifumi TadaEmail authorTakashi KumadaHidenori ToyodaMasayuki OhisaTomoyuki AkitaJunko Tanaka

    Toshifumi Tada
        1Email author
    Takashi Kumada
        1
    Hidenori Toyoda
        1
    Masayuki Ohisa
        2
    Tomoyuki Akita
        2
    Junko Tanaka
        2

    1.Department of Gastroenterology and HepatologyOgaki Municipal HospitalOgakiJapan
    2.Department of Epidemiology, Infectious Disease Control and PreventionHiroshima University Institute of Biomedical and Health SciencesHiroshimaJapan

Original Article—Liver, Pancreas, and Biliary Tract
First Online: 19 April 2018

    204 Downloads

Abstract
Background

The relationship between the hepatitis B e antigen (HBeAg) seroconversion and the long-term natural history of liver disease has not been sufficiently investigated.
Methods

A total of 408 [4352 person-year (PY) units] patients with chronic hepatitis B virus (HBV) without antiviral therapy were enrolled. The study patients were divided into three groups, as follows: Group A (2666 PY units), seroconverted of HBeAg at age < 40; Group B (413 PY units), seroconverted of HBeAg at age ≥ 40; Group C (1273 PY units), persistently HBeAg positive. Yearly transition probabilities from each liver state [chronic HBV infection, chronic hepatitis B, cirrhosis, hepatocellular carcinoma (HCC), and hepatitis B surface antigen (HBsAg) negativity] were calculated using the Markov chain model.
Results

In the analysis of 1 year liver disease state transition probabilities, the liver states remained almost the same in Group A. In Groups B and C, each liver state tended to progress to a worse state. Assuming a chronic hepatitis B state at age 40 as the starting condition for simulation over the next 40 years, the chronic hepatitis B state accounted for approximately 60% of males aged ≥ 50 and approximately 40% of females aged ≥ 60 in Group A, and the HBsAg-negative state accounted for approximately 30–40% of males and females aged ≥ 60. In Groups B and C, the probabilities of patients with cirrhosis and HCC gradually increased with age.
Conclusions

Not only patients with persistent HBeAg positive, but also patients with delayed HBeAg seroconversion showed poor prognosis of liver-related natural history.
Keywords
Hepatitis B virus Natural history Markov chain model Transition probability Hepatitis B e antigen seroconversion

StephenW

消化内科杂志

2018年11月，第53卷，第11期，第1196-1205页引用为
慢性乙型肝炎病毒感染患者的肝病长期自然史：使用马尔可夫链模型进行分析

作者
作者和附属机构

Toshifumi Tada电子邮件作者Takashi KumadaHidenori ToyodaMasayuki OhisaTomoyuki AkitaJunko Tanaka

Toshifumi Tada
1电子邮件作者
Takashi Kumada
1
Hidenori Toyoda
1
Masayuki Ohisa
2
Tomoyuki Akita
2
Junko Tanaka
2

1.胃肠病学和肝病学大垣市立医院大垣日本
2.流行病学，传染病控制和预防广岛大学生物医学与健康科学研究所广岛日本

原始文章 - 肝脏，胰腺和胆道
首次在线：2018年4月19日

204下载

抽象
背景

尚未研究乙型肝炎e抗原（HBeAg）血清转换与肝病的长期自然病史之间的关系。
方法

共有408名[4352人年（PY）单位]患者接受了无抗病毒治疗的慢性乙型肝炎病毒（HBV）患者。研究对象分为三组，如下：A组（2666 PY单位），血清转化的HBeAg，年龄<40; B组（413 PY单位），HBeAg血清转换，年龄≥40岁; C组（1273 PY单位），持续HBeAg阳性。使用马尔可夫链模型计算来自每个肝脏状态[慢性HBV感染，慢性乙型肝炎，肝硬化，肝细胞癌（HCC）和乙型肝炎表面抗原（HBsAg）阴性]的每年转变概率。
结果

在1年肝病状态转变概率的分析中，A组的肝脏状态几乎保持不变。在B组和C组中，每个肝脏状态倾向于进展到更糟的状态。假设40岁时的慢性乙型肝炎状态为未来40年模拟的起始条件，慢性乙型肝炎患者约占60岁男性≥50％，A组年龄≥60岁女性约占40％， HBsAg阴性状态占男性和女性年龄≥60的约30-40％。在B组和C组中，肝硬化和HCC患者的概率随年龄逐渐增加。
结论

不仅具有持续HBeAg阳性的患者，而且具有延迟的HBeAg血清转换的患者显示肝脏相关自然史的预后不良。
关键词
乙型肝炎病毒自然史马尔可夫链模型转换概率乙型肝炎e抗原血清转换