High Rates of Liver Cirrhosis and Hepatocellular Carcinoma in Chronic Hepatitis B Patients with Metabolic and Cardiovascular Comorbidities
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. High Rates of Liver Cirrhosis in Patient Subgroups with Metabolic and Cardiovascular Comorbidities
3.2. Clinical Outcome of CHB Patients with Different Metabolic Comorbidities
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
HBV | hepatitis B virus |
HDV | hepatitis delta virus |
HCC | hepatocellular carcinoma |
LTx | liver transplantation |
NAFLD | non-alcoholic fatty liver disease |
NA | nucleoside or nucleotide analog |
HBsAg | hepatitis B surface antigen |
HBeAg | hepatitis B early antigen |
IFN | pegylated interferon-alpha-2a |
AST | aspartate aminotransferase |
ALT | alanine aminotransferase |
GGT | gamma-glutamyltransferase |
AP | alkaline phosphatase |
INR | international normalized ratio |
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Total n = 602 | With Cirrhosis n = 50 | Without Cirrhosis n = 552 | Diabetes n = 23 | Obesity n = 13 | CHD n = 11 | Hypertension n = 43 | NAFLD n = 38 | |
---|---|---|---|---|---|---|---|---|
Male sex | 341 (56.64%) | 38 (76%) | 303 (54.89%) | 18 (78.26%) | 6 (46.15%) | 11 (100%) | 38 (88.37%) | 27 (71.05%) |
Median age, years (IQR) | 42 (33.25–52) | 58.5 (50–64) | 40 (32–50) | 57 (50.5–64) | 48 (46–61) | 62 (58–71.5) | 58 (50–67) | 46 (41–54.5) |
Cirrhosis | 50 (8.31%) | 50 (100%) | 0 (0%) | 11 (47.83%) | 6 (46.15%) | 7 (63.64%) | 15 (34.88%) | 4 (10.53%) |
NA treatment during follow-up | 225 (37.38%) | 42 (84%) | 183 (33.15%) | 14 (60.87%) | 9 (69.23%) | 11 (100%) | 41 (95.35%) | 15 (39.47%) |
IFN treatment during follow-up | 30 (4.98%) | 8 (16%) | 22 (3.99%) | 2 (8.7%) | 0 (0%) | 1 (9.09%) | 4 (9.30%) | 1 (2.63%) |
Median HBV DNA, IU/mL (IQR) | 1.71 × 103 (1.2 × 102–5.17 × 104) | 6.03 × 103 (1.2 × 101–8.19 × 105) | 1.72 × 103 (1.2 × 101–5.17 × 104) | 5 × 102 (1.25 × 101–1.51 × 105) | 5.17 × 102 (1.2 × 101–1.72 × 105) | 2 × 102 (1.2 × 101–2.59 × 104) | 9.48 × 101 (1.2 × 101–4.31 × 104) | 1.44 × 103 (1.2 × 101–3.45 × 104) |
Median HBsAg, IU/mL (IQR) | 5.05 × 103 (5 × 102–1.38 × 104) | 6.32 × 103 (5 × 102–1.21 × 104) | 4.66 × 103 (5 × 102–1.46 × 104) | 2.74 × 103 (5 × 102–1.72 × 104) | 6.4 × 103 (5 × 102–1.16 × 104) | 3.25 × 103 (5 × 102–8.35 × 103) | 2.59 × 103 (5 × 102–8.35 × 103) | 2.19 × 103 (5 × 102–1.02 × 104) |
HBeAg-positive | 56 (9.3%) | 12 (24%) | 44 (7.97%) | 7 (30.43%) | 3 (23.08%) | 3 (27.27%) | 4 (9.30%) | 3 (7.89%) |
Median INR (IQR) | 1.02 (0.97–1.09) | 1.13 (1.05–1.27) | 1.01 (0.97–1.07) | 1.06 (1.01–1.86) | 1.06 (1.01–1.08) | 1.2 (1.07–1.25) | 1.07 (0.99–1.14) | 1.11 (0.97–1.05) |
Median bilirubin, mg/dL (IQR) | 0.5 (0.4–0.7) | 0.7 (0.5–1.2) | 0.5 (0.4–0.7) | 0.5 (0.4–0.8) | 0.5 (0.4–0.7) | 1 (0.6–1.7) | 0.6 (0.4–0.9) | 0.5 (0.4–0.8) |
Median platelets, MRTD/L (IQR) | 217 (176.75–260) | 136 (80–186) | 221 (184–266) | 179 (112–220.5) | 202 (113–259) | 113 (67.25–183.5) | 198 (125.25–242.5) | 217 (194–279.5) |
Median ALT, U/L (IQR) | 31 (22–53.5) | 53 (33–94) | 31 (21–50) | 51 (27–52.5) | 38 (32–59) | 49 (30–79.75) | 35 (23–51.25) | 36 (27–53) |
Median GGT, U/L (IQR) | 27 (19–48) | 84 (43–202) | 26 (19–43) | 66 (31.5–92.5) | 72 (24–184) | 79 (68.25–177.5) | 58 (26–158) | 49 (27–72) |
Median albumin, g/L (IQR) | 43 (40–46) | 39 (35–41) | 43 (40–46) | 40.5 (39.75–43.25) | 40 (40–42) | 37 (29.75–42.5) | 40 (38–44) | 44 (40–46.75) |
Univariate Analysis (p-Value) | Multivariate Analysis (p-Value) | |
---|---|---|
Sex | 0.0031 | 0.61528 |
Age | <0.001 | <0.001 |
NA therapy | <0.001 | 0.0014 |
IFN therapy | <0.001 | 0.1885 |
HBeAg status | <0.001 | 0.0372 |
Diabetes | <0.001 | 0.0105 |
Obesity | 0.0048 | 0.8070 |
CHD | <0.001 | 0.8698 |
Hypertension | <0.001 | 0.0801 |
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Bockmann, J.-H.; Kohsar, M.; Murray, J.M.; Hamed, V.; Dandri, M.; Lüth, S.; Lohse, A.W.; Schulze-zur-Wiesch, J. High Rates of Liver Cirrhosis and Hepatocellular Carcinoma in Chronic Hepatitis B Patients with Metabolic and Cardiovascular Comorbidities. Microorganisms 2021, 9, 968. https://doi.org/10.3390/microorganisms9050968
Bockmann J-H, Kohsar M, Murray JM, Hamed V, Dandri M, Lüth S, Lohse AW, Schulze-zur-Wiesch J. High Rates of Liver Cirrhosis and Hepatocellular Carcinoma in Chronic Hepatitis B Patients with Metabolic and Cardiovascular Comorbidities. Microorganisms. 2021; 9(5):968. https://doi.org/10.3390/microorganisms9050968
Chicago/Turabian StyleBockmann, Jan-Hendrik, Matin Kohsar, John M. Murray, Vanessa Hamed, Maura Dandri, Stefan Lüth, Ansgar W. Lohse, and Julian Schulze-zur-Wiesch. 2021. "High Rates of Liver Cirrhosis and Hepatocellular Carcinoma in Chronic Hepatitis B Patients with Metabolic and Cardiovascular Comorbidities" Microorganisms 9, no. 5: 968. https://doi.org/10.3390/microorganisms9050968