Natural history of chronic HBV carriers in northern Italy: morbidity and mortality after 30 years

Calogero Camma', Mauro Manno, Roberta Gelmini, Francesco Giannini, Erica Villa, Francesca Miselli, Fabio Bassi, Fabio Bassi, Ilva Ferretti, Ilva Ferretti, Antonella Grottola, Filippo Schepis, Chiara Vecchi, Calogero Cammà, Marisa De Palma

Risultato della ricerca: Articlepeer review

204 Citazioni (Scopus)

Abstract

Background &amp; aims: Increased morbidity and mortality from liver disease have been reported in chronic hepatitis B surface antigen (HBsAg) carriers, but data on survival are equivocal. To assess the impact of hepatitis B virus (HBV) infection on survival and liver-related complications, we re-evaluated, after a mean follow-up of 30 years, a cohort of 296 blood donors excluded from donation 30 years ago when HBsAg screening became mandatory. Methods: Clinical and ultrasound examination and biochemical and virologic tests were performed. The cause of death was recorded and survival was compared with a control population of 157 HBV-negative blood donors selected at baseline. Results: Thirty-two (10.8%) cases and 14 controls (8.9%) (P = 0.625) had died; 3 of 32 (9.3%) and 1 of 14 (7.1%) deaths were liver-related. Hepatocellular carcinoma (HCC) caused death in 2 of 296 and 1 of 157 subjects (0.6% in each group). Alcohol-induced cirrhosis occured in the remaining subject. By Cox regression analysis, survival was independently predicted by older age, abnormal γ-glutamyl transpeptidase (GGT) levels, and presence of medical comorbidities at baseline. Unequivocal liver disease was found in 4 carriers only. No disease decompensation occurred during follow-up. Fifty-nine (32.2%) carriers cleared HBsAg (yearly incidence, 1.0%). Full-length serum HBV DNA was present in 32.2% of persistently HBsAg-positive individuals (average titer always <10 5 copies/mL). Conclusions: Over a 30-year period, chronic HBV carrier blood donors from Northern Italy did not develop clinically significant liver disease, hepatocellular cancer, or other liver-related morbidity or mortality at a higher rate than uninfected controls. The presence of medical comorbidities, older age at diagnosis, and abnormal GGT levels were independent predictors of death among chronic HBV carriers.
Lingua originaleEnglish
pagine (da-a)756-763
Numero di pagine8
RivistaGastroenterology
Volume127
Stato di pubblicazionePublished - 2004

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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