Past HBV Viral Load as Predictor of Mortality and Morbidity from HCC and Chronic Liver Disease in a Prospective Study

Chen, Gang; Wang, Lin; Shen, Fumin; Iloeje, Uchenna H.; London, William T.; Evans, Alison A.

doi:10.1111/j.1572-0241.2006.00647.x

Cited by 249 publications

(186 citation statements)

References 26 publications

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“…Participants with persistent elevation of serum HBV DNA level during follow-up had the highest HCC risk. These results were consistent with another prospective cohort study in 2,763 adult HBV carriers with 11 years of follow-up from Haimen city in China that assessed the relationship between HBV viral load at entry and mortality [34]. Compared to HBV carriers without detectable viremia, the relative risk for HCC mortality in those with low viral load (£2 · 10 4 IU/ml) was 1.7 (95% CI, 0.5-5.7) and 11.2 (95% CI, 3.6-35.0) in those with high viral load ( ‡2 · 10 4 /ml).…”

Section: Serum Hbv Dna Levelsupporting

confidence: 91%

Role of viral factors in the natural course and therapy of chronic hepatitis B

Kao

2007

Hepatol Int

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Hepatitis B virus (HBV) infection is a global health problem that causes a wide spectrum of liver disease, including acute or fulminant hepatitis, inactive carrier state, chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). The pathogenesis of hepatocyte damage associated with HBV is mainly through immune-mediated mechanisms. On the basis of the virus and host interactions, the natural history of HBV carriers who are infected in early life can be divided into four dynamic phases. The frequency, extent, and severity of hepatitis flares or acute exacerbation in the second immune clearance and/or fourth reactivation phase predict liver disease progression in HBV carriers. In the past decade, hepatitis B viral factors including serum HBV DNA level, genotype, and naturally occurring mutants predictive of clinical outcomes have been identified. The higher the serum HBV DNA level after the immune clearance phase, the higher the incidence of adverse outcomes over time. In addition, high viral load, genotype C, basal core promoter mutation, and pre-S deletion correlate with increased risk of cirrhosis and HCC development. As to the treatment of chronic hepatitis B, patients with high HBV DNA level and genotype C or D infection are shown to have a worse response to interferon therapy. In conclusion, serum HBV DNA level, genotype, and naturally occurring mutants are identified to influence liver disease progression and therapy of chronic hepatitis B. More investigations are needed to clarify the molecular mechanisms of the viral factors involved in the pathogenesis of each stage of liver disease and the response to antiviral treatments.

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Section: Serum Hbv Dna Levelsupporting

confidence: 91%

Role of viral factors in the natural course and therapy of chronic hepatitis B

Kao

2007

Hepatol Int

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“…Yang et al [6] reported that the incidence of HCC was significantly higher in those who were HBsAg and HBeAg positive than in those who were HBsAg positive only. Recently, this was confirmed by showing a correlation between baseline HBV DNA levels in asymptomatic adult HBsAg carriers and the risk of HCC [10][11][12][13].…”

Section: Hepatitis B Infectionmentioning

confidence: 83%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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“…Its results have been replicated in a second study that was also conducted in Chinese patients. 82 The relationship between viral load and liver disease outcome has been found in other studies around the world including West Africa, China, and Japan, but primarily in Asians.…”

Section: Limitationsmentioning

confidence: 87%

Evaluation of the Cost-Effectiveness of Entecavir Versus Lamivudine in Hepatitis BeAg-Positive Chronic Hepatitis B Patients

Yuan¹,

Iloeje²,

Hay³

et al. 2008

JMCP

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BACKGROUND: As new treatment options for chronic hepatitis B virus (HBV) become available, evaluations of cost-effectiveness become important. Entecavir is a deoxyguanine nucleoside analogue approved by the U.S. Food and Drug Administration in March 2005 for HBV infection in adults with evidence of active viral replication and either evidence of persistent elevations in serum aminotransferases (alanine aminotransferase or aspartate aminotransferase) or histologically active disease. Entecavir has demonstrated greater suppression of viral replication compared with lamivudine, but also has a relatively higher drug acquisition cost in the United States.

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Past HBV Viral Load as Predictor of Mortality and Morbidity from HCC and Chronic Liver Disease in a Prospective Study

Abstract: In this prospective study, viral load is associated with increased mortality from HCC and CLD in HBV-infected subjects. Viral load may be a useful prognostic tool in HBV infection, and interventions aimed at its reduction should be explored.

Cited by 249 publications

References 26 publications

Role of viral factors in the natural course and therapy of chronic hepatitis B

Role of viral factors in the natural course and therapy of chronic hepatitis B

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Evaluation of the Cost-Effectiveness of Entecavir Versus Lamivudine in Hepatitis BeAg-Positive Chronic Hepatitis B Patients

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