Meta-Analysis of Risk Factors for Development of Liver Cirrhosis in Chronic Hepatitis B Patients

Abstract

Chronic hepatitis B virus (HBV) infection and chronic hepatitis C virus (HCV) are main reasons for the development of liver cirrhosis (LC) on a worldwide scale. Chronic HBV infection is a main reason for the development of LC in high-risk areas, for example, China and Africa, whereas chronic HCV infection is a main reason in developed countries. In China, the harm of LC is serious, and 30 million of chronic hepatitis B (CHB) patients is the major source of LC and the one-year cumulative incidence rate of LC in CHB patients was 2.1%-6%. The risk factors of the development of LC in CHB patients reported were controversial. Therefore, we took CHB as participants, and we searched for studies in Chinese Medical Journal Database, Pubmed, Elsevier, Springer, Wiley, OVID, and EBSCO via BoKu data service platform, and did a meta-analysis and evaluated whether those published risk factors changed the development risk of LC. Both odds ratio (OR) and mean difference (MD) with 95% confi dence intervals (CI) were calculated by Review Manager 5.0. In this meta-analysis, 2928cases and 6530controls from 29 studies were analyzed. The pooled OR with 95% CI for 5 factors analyzed were: drinking alcohol 1.32 (1.11, 1.59), cigarette smoking 1.26 (1.04, 1.52), hepatitis B e antigen (HBeAg) seropositivity 0.42 (0.19, 0.94), a family history of hepatitis B 1.95 (1.05, 3.62), and male gender 1.33 (1.08, 1.65), respectively. And the pooled MD with 95% CI for 6 factors analyzed were: serum aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio 0.29(0.18,0.39), serum total bilirubin (TBil) levels 8.25(5.58,10.92)umol/L, duration of hepatitis B 2.68(2.21,3.15) years, age 7.37(4.60,10.14)years, serum alpha fetoprotein (AFP) levels-0.91(-16.04,14.22) ug/L, and serum HBV DNA levels 0.37 (-0.28, 1.02)copies/ml, respectively. In CHB patients, habits of drinking alcohol and cigarette smoking, elevated serum levels of TBil and serum AST/ALT ratio, increased duration of hepatitis B, a family of hepatitis B, male gender and older age can increase the risk of LC development.

Correlation of Mac-2 Binding Protein Glycosylation Isomer (M2BPGi) with Liver Transient Elastography Results in Evaluating Liver Fibrosis in Chronic Hepatitis B Patients

“…34,41 This can be explained by a meta-analysis study by Cai et al who found that age, ratio of AST, and ALT were other influential factors causing liver fibrosis in chronic hepatitis B patients in addition to other factors such as male sex, family history of hepatitis B, increased duration of hepatitis B, alcohol drinking habit, smoking, and increased total bilirubin levels. 53 A study by Yang YT et al reported that platelet count can be used as a marker of the severity of liver injury and liver fibrosis in chronic hepatitis B infection. 54 In patients with advanced liver disease and decompensated cirrhosis, low serum albumin is caused by impaired liver function and albumin synthesis.…”

Risk of Liver Cirrhosis in HBV/HCV-Infected Individuals with First-Degree Relatives Who Have Liver Cancer: Development and Validation of a Simple Model

“…Second, previous studies and most of the reported noninvasive models were based on viral or liver factors, such as aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, HBV DNA viral load, HCV RNA load, AST-to-platelet ratio index, and platelet count (19)(20)(21)(22)(23)(24). However, data are limited for the noninvasive models based on the host factors, which are also related with liver cirrhosis (25). The viral or liver indices could only be obtained by laboratory testing; the results were not immediately available for patients, and the cost also led to limited availability, especially in resource-limited settings (26).…”