HBV DNA Level Predicts the Incidence of Liver Cirrhosis in Chronic HBV Infection
Chronic hepatitis B patients are at increased risk of developing liver cirrhosis.?Cirrhosis develops as a result of hepatic inflammation and subsequent fibrosis.? Ongoing viral replication is associated with hepatic inflammatory activity and suppression of viral replication in clinical trials is associated with improvements in liver histology.?
An association between elevated HBV DNA level and progression to cirrhosis has not been shown in a large epidemiological setting.?This study was carried out to examine if increasing levels of HBV DNA is associated with increasing risk of cirrhosis.?
A population based prospective cohort study of 3,851 HBV infected subjects was established from seven townships in Taiwan between 1991 and 1992.?
Cohort entry serum samples were tested for HBV DNA by PCR, and the diagnosis of cirrhosis was by ultrasonography and ascertained by medical records review.?
Cirrhosis incidence rate per person year of follow-up (PYFU) for each strata of HBV DNA was calculated.
Results
?span style='font:7.0pt "Times New Roman"'> Of the 3,851 subjects, 75 subjects diagnosed with cirrhosis within 6 months of enrollment were excluded leaving 3774 subjects.?
?During 42,114.9 person-years of follow-up, 395 cirrhosis cases were newly diagnosed.
?span style='font:7.0pt "Times New Roman"'> The incidence rate of cirrhosis ranged from 386.1/100,000 PYFU for those with HBV DNA <300 copies/ml to 2,575.7/100,000 PYFU for those with HBV DNA ?/span> 106 copies/mL (test of trend: p<0.0001) in a dose dependent manner.?
?span style='font:7.0pt "Times New Roman"'> With the undetectable group as reference, and adjusting for gender, age, habits of cigarette smoking, and alcohol consumption, and antibodies against hepatitis C virus, the risk of cirrhosis started increasing at HBV DNA level of 104 RRadj 2.4 and was 9.3 for those who had serum HBV DNA level > 106 copies/ml.?
Conclusion
In conclusion, the authors write, ?/span>HBV DNA level is a strong predictor of cirrhosis risk.?The incidence of cirrhosis increases with HBV DNA level in a dose dependent manner.?It is expected therefore that reducing the HBV DNA should conversely decrease cirrhosis risk in chronic hepatitis B patients.?/font>
05/18/05
Reference
U H Iloeje and others. Serum Hepatitis B Virus (HBV) DNA Level Predicts the Incidence Of Liver Cirrhosis in Persons Chronically Infected With HBV. Abstract 925. Digestive Disease Week 2005. May 14-18, 2005. Chicago, IL. | 
发表于 2005-5-31 03:17
