Meta-Analysis of Risk Factors for Development of Liver Cirrhosis in Chronic Hepatitis B Patients (original) (raw)
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JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY, 2024
Background and aims: Chronic viral hepatitis B (CHB)-infected patients occasionally develop cirrhosis despite having persistent viral suppression with antiviral therapy. We aimed to identify risk factors for developing cirrhosis in hepatitis B virus (HBV)-suppressed patients. Methods: We conducted a case–control study involving 120 noncirrhotic CHB-infected patients achieving viral suppression with antiviral treatment, with 40 cases developing cirrhosis and 80 age-, sex-, and Fibrosis-4 (FIB-4)-matched controls. Clinical and laboratory data at viral suppression, including body mass index (BMI), comorbidities, pretreatment HBV viral load, HBe antigen status, hepatitis C virus (HCV) and HIV coinfections, liver chemistries, and AST to Platelets Ratio Index (APRI) values, were retrospectively abstracted. Risk factors for cirrhosis post-HBV suppression were identified using Cox proportional hazard analysis. Results: Case and control groups had similar ages (51.4 ± 9.9 vs. 51.4 ± 10.2 years), proportions of males (80% vs. 80%), and FIB-4 values (1.32 vs. 1.31). The cirrhosis group showed significantly higher BMI (25.1 vs. 22.7, P = 0.01) and more diabetes prevalence (50.0% vs. 26.3%, P = 0.01), while other comorbidities and laboratory parameters were comparable (P > 0.05). By univariate analysis, BMI >23 kg/m2, diabetes, and APRI >0.7 were significantly associated with cirrhosis, with hazard ratios (HRs) (95%CI) of 2.99 (1.46–6.13), 2.31 (1.23–4.36), and 2.71 (1.05–6.99), P = 0.003, 0.010, and 0.039, respectively. In multivariate analyses adjusted for APRI, BMI>23 kg/m2 remained significantly associated with cirrhosis (aHR: 2.76, P = 0.006), while diabetes showed borderline significance (aHR: 1.99, P = 0.072). Conclusions: In HBV-infected patients achieving viral suppression with therapy, a BMI >23 kg/m2 increases the risk of cirrhosis. Therefore, a comprehensive approach addressing metabolic factors is imperative for preventing disease progression in HBV-infected patients. ( J CLIN EXP HEPATOL 2024;14:101388)
The Professional Medical Journal, 2021
Objective: Liver cirrhosis is one of the most widespread diseases in underdeveloped countries. Study Design: Cross Sectional Study. Setting: Nishtar Hospital Multan. Period: January 2020 to March 2020. Material & Methods: Three hundred and ninety seven of admitted patients were included and patients falling in class C of child Turcotte Pugh classification of liver cirrhosis were determined. Prevalence of hepatocellular carcinoma and cause of cirrhosis in these patients was also determined. Statistical Package for Social Sciences (SPSS 23.0) was used for analysis. Results: Out of 397 patients included in the study 25.4 % or 101 had class C cirrhosis, out of these 5.94% or 6 also had hepatocellular carcinoma. With respect to age of initial diagnosis of the illness 25.7% or 26 were in age interval 31-40yrs, 24.8% or 25 in interval 41-50yrs, 20.8% or 21 in interval 51-60 yrs. Hepatitis C (67.3%) comes out to be the commonest of all causes of chronic liver disease, followed by other caus...
Clinical epidemiological study of Hepatitis B and C
2015
Ali et al. / Current Science Perspectives 1(2) (2015) 91-95 92 HCV patients from the different part of the world can be divided into six main genotypes. The major clinical difference between genotypes is the response to antiviral therapy (Simmonds et al., 1999). The transmission of HCV is declining worldwide as a result of the screening of blood products and implementation of standard precautions (Armstrong et al., 2000). Normalization of liver enzyme levels, viral suppression and clearance, reduction in histologic scores of liver inflammation or fibrosis, and combinations of these outcomes have been used to measure response to antiviral drugs or development of antiviral resistance (Lok and McMahon, 2007; Hoofnagle et al., 2007). Progression from acute to chronic HBV infection is influenced by the patient's age at acquisition of the virus; age is also related to the clinical expression of HBV infection between high-prevalence (e.g., Asian) and lowprevalence (e.g., Western) count...