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Factors associated with progression to hepatocellular carcinoma and to death from liver complications in patients with HBsAg-positive cirrhosis. Dig Dis Sci 2009 Jun;54(6):1337-46

Date

02/27/2009

Pubmed ID

19242792

DOI

10.1007/s10620-009-0747-y

Scopus ID

2-s2.0-67349237234 (requires institutional sign-in at Scopus site)   30 Citations

Abstract

BACKGROUND AND AIMS: Hepatitis B viral markers and liver tests were used as predictors for development of hepatocellular carcinoma and progression to end-stage liver disease in 128 cirrhosis patients with hepatitis B.

RESULTS: During a median follow-up of 63.5 months, 28 patients (21.9%) developed HCC and 36 (28.1%) died from non-HCC liver deaths. By multivariate analysis, independent predictors of HCC development and their hazard ratios were high alfa-fetoprotein (HR2.83, 95% CI 1.60-5.00, P = 0.0003), negative HBeAg (HR2.33, 95% CI 1.04-5.29, P = 0.04), and low alanine aminotransferase value (HR1.42, 95% CI 1.08-1.89, P = 0.02). Independent predictors of non-HCC liver deaths were HBeAg positivity (HR3.39, 95% CI 1.16-9.93, P = 0.02), decrease albumin (HR1.61, 95% CI 0.99-2.63, P = 0.05), decrease platelet count (HR2.54, 95% CI 1.03-6.25, P = 0.04), high ALT value (HR1.22, 95% CI 1.03-1.43, P = 0.02), and onset of encephalopathy (HR3.34, 95% CI 1.21-9.27, P = 0.02).

CONCLUSIONS: HBeAg negativity, elevated AFP, and low ALT values predicted HCC development, while HBeAg positivity, abnormal liver tests, and low platelet counts identified patients with non-HCC liver deaths.

Author List

Tong MJ, Hsien C, Song JJ, Kao JH, Sun HE, Hsu L, Han SH, Durazo FA, Saab S, Blatt LM

Author

Francisco A. Durazo MD Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Antiviral Agents
Biomarkers
Carcinoma, Hepatocellular
Female
Hepatitis B
Hepatitis B Surface Antigens
Humans
Liver Cirrhosis
Liver Transplantation
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Risk Factors
Young Adult