Background & 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 gamma-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.

Natural history of chronic HBV in northern Italy: Morbidity and morality after 30 years / M., Manno; C., Camma; SCHEPIS, Filippo; F., Bassi; GELMINI, Roberta; F., Giannini; F., Miselli; GROTTOLA, Antonella; I., Ferretti; C., Vecchi; M., De Palma; VILLA, Erica. - In: GASTROENTEROLOGY. - ISSN 0016-5085. - STAMPA. - 127(2004), pp. 756-763.

Natural history of chronic HBV in northern Italy: Morbidity and morality after 30 years

SCHEPIS, Filippo;GELMINI, Roberta;GROTTOLA, Antonella;VILLA, Erica
2004

Abstract

Background & 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 gamma-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.
127
756
763
Natural history of chronic HBV in northern Italy: Morbidity and morality after 30 years / M., Manno; C., Camma; SCHEPIS, Filippo; F., Bassi; GELMINI, Roberta; F., Giannini; F., Miselli; GROTTOLA, Antonella; I., Ferretti; C., Vecchi; M., De Palma; VILLA, Erica. - In: GASTROENTEROLOGY. - ISSN 0016-5085. - STAMPA. - 127(2004), pp. 756-763.
M., Manno; C., Camma; SCHEPIS, Filippo; F., Bassi; GELMINI, Roberta; F., Giannini; F., Miselli; GROTTOLA, Antonella; I., Ferretti; C., Vecchi; M., De Palma; VILLA, Erica
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/307960
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