Long-term prognosis analysis of chronic hepatitis B patients followed up for 25 years:Retrospective cohort study
10.3969/j.issn.1006-5725.2024.07.014
- VernacularTitle:慢性乙型病毒性肝炎患者随访25年长期预后分析
- Author:
Xiaoya YANG
1
;
Tianqi HONG
;
Kaili GE
;
Renjie ZHANG
;
Chunshan WEI
Author Information
1. 广州中医药大学第四临床医学院(广东深圳 518033)
- Keywords:
chronic hepatitis B;
age;
retrospective cohort study;
risk factor
- From:
The Journal of Practical Medicine
2024;40(7):962-965,971
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of age on the incidence of cirrhosis and liver cancer in patients with chronic hepatitis B.Methods 279 patients with chronic hepatitis B were divided into the senior group and the younger group according to the age of the patients.The cumulative incidence of cirrhosis and liver cancer during 25 years of follow-up was calculated by using SPSS and R language through the long-term follow-up of HIS system,and the risk factors were analyzed by multivariate logistic regression.Results During follow-up,24 cases developed cirrhosis and 12 cases developed liver cancer.The cumulative incidence of liver cirrhosis was 1.5%,2.1%,5.4%,11.6%and 15.5%in the 5-year,10-year,15-year,20-year and 25-year group,and 5.5%,9.8%,22.9%,29.0%and 52.1%in the elderly,respectively.The difference between the younger age group and senior age group was statistically significant(P<0.001).A total of 2 risk factors(age and follow-up time)were included in the regression model.Two cases in the younger group developed into liver cancer after 17 and 21 years of follow-up,respectively.The cumulative incidence rates at 5,10,15,20 and 25 years were 1.8%,3.8%,18.5%,21.8%and 26.7%.A total of five factors(initial age,HBV-DNA load,HBV-DNA turned negative before the end-point,follow-up time,and sex)were included in the regression model.Conclusions The incidence of cirrhosis and liver cancer in CHB patients aged≥40 years,especially in male patients,is significantly higher than younger CHB patients.Timely initiation of antiviral therapy can delay disease progression and reduce the incidence of termi-nal liver disease.Whether antiviral therapy should be initiated for people aged 30 to 40 years remains to be studied.
