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Model of life expectancy of chronic hepatitis B carriers in an endemic region.

Wang T - J Epidemiol (2009)

Bottom Line: When e antigen status remains positive, absolute liver mortality rates climb significantly after age 40 years.CLD is a proportionally higher threat for e antigen-negative females than for other subgroups.Males have higher liver-related mortality at all ages.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Health Sciences, Queen's University, Kingston, ON, Canada. wang.tao@mail.com

ABSTRACT

Background: Chronic infection with hepatitis B (HBV) is a known risk factor for increased mortality from hepatocellular carcinoma (HCC) and chronic liver disease (CLD). However, the specific effects of chronic HBV infection on life expectancy have not been adequately studied. Taiwan is endemic for HBV infection, and thus provides sufficient information for such estimates.

Methods: Population mortality statistics, combined with data on the contribution of HBV to HCC and CLD deaths, were used to model carrier mortality by sex and e antigen status. An abridged life table was used to calculate carrier life expectancy.

Results: Among both males and females, those who are e antigen-positive are more likely to die from HCC than from CLD. When e antigen status remains positive, absolute liver mortality rates climb significantly after age 40 years. CLD is a proportionally higher threat for e antigen-negative females than for other subgroups. Males have higher liver-related mortality at all ages. A small decrease in life expectancy, from 82.0 to 80.1 years, was found for female noncarriers versus female carriers; a larger discrepancy was observed for males-from 76.2 to 71.8 years. In comparison to noncarriers, the lifetime relative risk of mortality is 1.35 for male carriers and 1.16 for female carriers.

Conclusions: These results indicate that chronic HBV infection results in significant liver-related mortality; however, carriers retain a satisfactory life expectancy.

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Related in: MedlinePlus

Age-specific mortality among male hepatitis B carriers caused by hepatocellular carcinoma and chronic liver disease, by e antigen status.
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fig02: Age-specific mortality among male hepatitis B carriers caused by hepatocellular carcinoma and chronic liver disease, by e antigen status.

Mentions: Regarding mortality trends, e antigen-positive men are significantly more likely to die from HCC than from CLD; e antigen-negative men have less divergence between the rates for HCC and CLD (Figure 2). Among females, chronic liver disease represents a relatively higher proportion of liver-related deaths (Figure 3). Among those aged 80 to 84 years, HCC carries the highest risk among both men and women. Since e antigen conveys a 6.27 RR for HCC mortality, e-positive adults are always at higher risk. When subgrouped by sex and HbeAg status, peak HCC mortality varies greatly. For example, e antigen-positive males have a peak HCC mortality around 7000 per 105. In contrast, the peak for e antigen-negative females is approximately 370 per 105. Thus, there is nearly a 20-fold difference in peak HCC mortality between the highest and lowest risk carrier subpopulations. Chronic liver disease mortality decreases slightly among adults aged 85 to 89 years and is less influenced by e antigen status. There is also less of a gender gap in CLD mortality in that age group, although males still have a worse prognosis.


Model of life expectancy of chronic hepatitis B carriers in an endemic region.

Wang T - J Epidemiol (2009)

Age-specific mortality among male hepatitis B carriers caused by hepatocellular carcinoma and chronic liver disease, by e antigen status.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3924100&req=5

fig02: Age-specific mortality among male hepatitis B carriers caused by hepatocellular carcinoma and chronic liver disease, by e antigen status.
Mentions: Regarding mortality trends, e antigen-positive men are significantly more likely to die from HCC than from CLD; e antigen-negative men have less divergence between the rates for HCC and CLD (Figure 2). Among females, chronic liver disease represents a relatively higher proportion of liver-related deaths (Figure 3). Among those aged 80 to 84 years, HCC carries the highest risk among both men and women. Since e antigen conveys a 6.27 RR for HCC mortality, e-positive adults are always at higher risk. When subgrouped by sex and HbeAg status, peak HCC mortality varies greatly. For example, e antigen-positive males have a peak HCC mortality around 7000 per 105. In contrast, the peak for e antigen-negative females is approximately 370 per 105. Thus, there is nearly a 20-fold difference in peak HCC mortality between the highest and lowest risk carrier subpopulations. Chronic liver disease mortality decreases slightly among adults aged 85 to 89 years and is less influenced by e antigen status. There is also less of a gender gap in CLD mortality in that age group, although males still have a worse prognosis.

Bottom Line: When e antigen status remains positive, absolute liver mortality rates climb significantly after age 40 years.CLD is a proportionally higher threat for e antigen-negative females than for other subgroups.Males have higher liver-related mortality at all ages.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Health Sciences, Queen's University, Kingston, ON, Canada. wang.tao@mail.com

ABSTRACT

Background: Chronic infection with hepatitis B (HBV) is a known risk factor for increased mortality from hepatocellular carcinoma (HCC) and chronic liver disease (CLD). However, the specific effects of chronic HBV infection on life expectancy have not been adequately studied. Taiwan is endemic for HBV infection, and thus provides sufficient information for such estimates.

Methods: Population mortality statistics, combined with data on the contribution of HBV to HCC and CLD deaths, were used to model carrier mortality by sex and e antigen status. An abridged life table was used to calculate carrier life expectancy.

Results: Among both males and females, those who are e antigen-positive are more likely to die from HCC than from CLD. When e antigen status remains positive, absolute liver mortality rates climb significantly after age 40 years. CLD is a proportionally higher threat for e antigen-negative females than for other subgroups. Males have higher liver-related mortality at all ages. A small decrease in life expectancy, from 82.0 to 80.1 years, was found for female noncarriers versus female carriers; a larger discrepancy was observed for males-from 76.2 to 71.8 years. In comparison to noncarriers, the lifetime relative risk of mortality is 1.35 for male carriers and 1.16 for female carriers.

Conclusions: These results indicate that chronic HBV infection results in significant liver-related mortality; however, carriers retain a satisfactory life expectancy.

Show MeSH
Related in: MedlinePlus