首页|Impact of comorbidities on the severity of chronic hepatitis B at presentation

Impact of comorbidities on the severity of chronic hepatitis B at presentation

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AIM:To evaluate the clinical relevance of each cofactor on clinical presentation of chronic hepatitis B.METHODS:Out of 1366 hepatitis B surface antigen (HBsAg) positive subjects consecutively observed in 79Italian hospitals,53 (4.3％) showed as the only cofactor hepatitis D virus (HDV) infection [hepatitis B virus (HBV)/HDV group],130 (9.5％) hepatitis C virus (HCV)(group HBV/HCV),6 (0.4％) human immunodeficiency virus (HIV) (group HBWHIV),138 (10.2％) alcohol abuse (group HBV/alcohol); 109 (8.0％) subjects had at least two cofactors and 924 were in the cofactor-free (CF) group.RESULTS:Compared with patients in group CF those in group HBV/alcohol were older and more frequently had cirrhosis (P ＜ 0.001),those in group HBV/HDV were younger (P ＜ 0.001),more frequently resided in the south of the country and had cirrhosis (P ＜0.001),those in group HBV/HCV were older (P ＜ 0.001) and more frequently had cirrhosis (P ＜ 0.001).These cofactors were all independent predictors of liver cirrhosis in HBsAg positive patients.Multivariate analysis showed that an older age [odds ratio (OR) 1.06,95％ CI:1.05-1.08],alcohol abuse with more than 8 drinks daily (OR 2.89,95％ CI:1.81-4.62) and anti-HDV positivity (OR 3.48,95％ CI:2.16-5.58) are all independently associated with liver cirrhosis.This association was found also for anti-HCV positivity in univariate analysis,but it was no longer associated (OR 1.23,95％ CI:0.84-1.80)at multivariate analysis.CONCLUSION:Older age,HDV infection and alcohol abuse are the major determinants of severe liver disease in chronic HBV infection,while HCV replication plays a lesser role in the severity of hepatic damage.

Chronic hepatitis BHepatitis B virus/hepatitis D virus dual infectionHepatitis B virus/hepatitis C virus dual infectionAlcohol abuse

Evangelista Sagnelli、Tommaso Stroffolini、Alfonso Mele、Michele Imparato、Caterina Sagnelli、Nicola Coppola、Piero Luigi Almasio

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Department of Public Medicine, Section of Infectious Diseases,Second University of Naples, 80132 Naples, Italy

Department of Infectious and Tropical Diseases, Policlinico Umberto I, 00161 Rome, Italy

Laboratory of Epidemiology, Clinical Epidemiology Unit, Istituto Superiore di Sanità, 00161 Rome, Italy

Department of Clinical and Experimental Medicine and Surgery "F. Magrassi e A.Lanzara", Second University of Naples, 80132 Naples, Italy

Gastroenterology Unit, University of Palermo, 90127 Palermo, Italy

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Progetto di Ricerca di Interesse Nazionale 2000 and in part with a grant from the Viral Hepatitis ProjectIstituto Superiore di Sanità,Dthis study was performed with the support of Glaxo Smith-Kline

leg.vo 30/12/1992 n.502

2012

10.3748/wjg.v18.i14.1616

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(14)
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