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©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
Different natural courses of chronic hepatitis B with genotypes B and C after the fourth decade of life
Tatsuji Maeshiro, Shingo Arakaki, Takako Watanabe, Hajime Aoyama, Joji Shiroma, Tsuyoshi Yamashiro, Tetsuo Hirata, Akira Hokama, Fukunori Kinjo, Tomofumi Nakayoshi, Tomokuni Nakayoshi, Masashi Mizokami, Jiro Fujita, Hiroshi Sakugawa
Tatsuji Maeshiro, Shingo Arakaki, Takako Watanabe, Hajime Aoyama, Joji Shiroma, Tetsuo Hirata, Akira Hokama, Jiro Fujita, Control and Prevention of Infectious Disease (First Department of Internal Medicine), Department of Medicine and Therapeutics, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
Tsuyoshi Yamashiro, Department of Blood transfusion medicine, Ryukyu University Hospital, Okinawa, Japan
Fukunori Kinjo, Department of Endoscopy, Ryukyu University Hospital, Okinawa, Japan
Tomofumi Nakayoshi, Department of Internal Medicine, Tomishiro Central Hospital, Okinawa, Japan
Tomokuni Nakayoshi, Hiroshi Sakugawa, Department of Internal Medicine, Heart Life Hospital, Okinawa, Japan
Masashi Mizokami, Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Tatsuji Maeshiro, Control and Prevention of Infectious Disease, Department of Medicine and Therapeutics, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan. f994908@med.u-ryukyu.ac.jp
Telephone: +81-98-8951144 Fax: +81-98-8951414
Received: May 29, 2007
Revised: June 13, 2007
Accepted: June 18, 2007
Published online: September 14, 2007
AIM: To investigate the different impact of genotypes B and C on the development of liver cirrhosis (LC) among different age groups of patients with chronic hepatitis B (CH-B).
METHODS: We examined the outcome of 121 patients with CH-B, divided by age and genotype. Univariate analyses were used to compare different groups. The Cox proportional hazard model was employed to evaluate factors affecting the development of LC.
RESULTS: In patients < 30 years old, there were no significant predictors for development of LC. However, in patients ≥ 30 years old, genotype C was the only significant predictor. In the genotype C group, 8 of 12 patients who progressed to LC were 30-49 years old at initial diagnosis of chronic hepatitis (7 patients were positive for HBeAg). In the genotype B group, 4 of 8 patients who developed LC were ≥ 50 years old at initial diagnosis and were HBeAg-negative.
CONCLUSION: The rate of development of LC was comparable in patients infected with genotypes B and C when CH-B occurred at < 30 years old. However, CH-B patients infected with genotype C showed poor prognosis if they were 30-49 years old and were positive for HBeAg. Age-specific natural course of CH-B should be considered when patients with CH-B are treated with antiviral drugs.
