Demographics and outcomes of hepatitis B and D: a 10-year retrospective analysis in a Swiss tertiary referral center

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Serval ID
serval:BIB_E6CA05250B50
Type
PhD thesis: a PhD thesis.
Collection
Publications
Institution
Title
Demographics and outcomes of hepatitis B and D: a 10-year retrospective analysis in a Swiss tertiary referral center
Author(s)
Vieira Barbosa Joana Sofia
Director(s)
Moradpour Darius
Codirector(s)
Fraga Montserrat
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2021
Language
english
Abstract
Background
Hepatitis B virus (HBV) is a major global health challenge with approximately 250–350 mil- lion chronically infected individuals. An improved understanding of the demographic fea- tures and outcomes of chronic HBV infection and hepatitis D virus (HDV) infection in low- endemic areas may improve prevention, early identification and management both at indi- vidual and community levels. Here, we retrospectively analyzed the demographic and clini- cal characteristics, treatment rates and outcomes of adult patients with chronic HBV infection with or without HDV coinfection examined at Lausanne University Hospital, Swit- zerland over a 10-year period.
Methods
We analyzed the medical records of all adult patients with chronic HBV and HDV infection examined in our center between 2007 and 2016. Liver-related outcome was defined as the occurrence of cirrhosis, hepatocellular carcinoma, liver transplantation or liver-related death. Analyses were performed using logistic regression and results were reported as odds ratio (OR) and 95% confidence interval (CI).
Results
Of 672 consecutive patients, 421 (62.6%) were male, median age was 36 years (interquar- tile range, 28–46 years), and 233 (34.7%) were of African origin. The prevalence of HDV coinfection was 7.1% and the proportion of anti-HDV-positive patients with detectable HDV RNA was 70.0%. In multivariate analysis, HDV coinfection was the strongest predictor for liver-related outcome (OR 6.06, 95% CI 2.93–12.54, p<0.001), followed by HBeAg positivity (OR 2.47, 95% CI 1.30–4.69, p = 0.006), age (OR per 10-year increase 2.03, 95% CI 1.63–2.52, accuracy of the multivariate model was high (receiver operator characteristic area under the curve 0.81).
Conclusion
This retrospective study underscores the importance of migration in the epidemiology of chronic hepatitis B in low-endemic areas. HDV coinfection, HBeAg positivity and age pre- dicted liver-related outcomes while female sex had a protective effect.
Create date
03/11/2021 12:18
Last modification date
12/11/2021 7:14
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