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Development and evaluation of a baseline-event-anticipation score for hepatitis delta.

Calle Serrano B, Großhennig A, Homs M, Heidrich B, Erhardt A, Deterding K, Jaroszewicz J, Bremer B, Koch A, Cornberg M, Manns MP, Buti M, Wedemeyer H - J. Viral Hepat. (2014)

Bottom Line: The baseline-event-anticipation score (BEA score) was developed based on variables associated with the development of liver-related clinical complications.Age, region of origin, presence of cirrhosis, albumin, INR, hyperbilirubinemia and thrombocytopenia were all associated with the development of an event in the training cohort.Delta hepatitis is associated with a very severe long-term outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany; German Center for Infection Research (DZIF), Partner Side HepNet Study-House, Hannover, Germany.

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(a) Patient recruitment, inclusion and exclusion criteria. Only 75 of 364 screened HBsAg-positive patients met all inclusion and none of the exclusion criteria. At baseline, 37 patients already had liver cirrhosis. (b) Long-term outcome of hepatitis D. Eighteen of 38 patients with chronic hepatitis at baseline developed liver cirrhosis in the 2–16 years they were followed up. Decompensation was the most frequent liver-related complication (32 of 56 patients with cirrhosis). Overall, eight patients developed hepatocellular carcinoma, six patients died (one of unknown cause) and 16 received a liver transplantation. Twenty-two patients did not undergo any event, only two patients seroconverted HBsAg and a total of 20 patients were lost to follow-up. HBsAg, hepatitis B surface antigen; antiHDV, antibodies against hepatitis delta virus; HIV, human immunodeficiency virus; HCC, hepatocellular carcinoma; OLT, orthotropic liver transplantation.
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fig01: (a) Patient recruitment, inclusion and exclusion criteria. Only 75 of 364 screened HBsAg-positive patients met all inclusion and none of the exclusion criteria. At baseline, 37 patients already had liver cirrhosis. (b) Long-term outcome of hepatitis D. Eighteen of 38 patients with chronic hepatitis at baseline developed liver cirrhosis in the 2–16 years they were followed up. Decompensation was the most frequent liver-related complication (32 of 56 patients with cirrhosis). Overall, eight patients developed hepatocellular carcinoma, six patients died (one of unknown cause) and 16 received a liver transplantation. Twenty-two patients did not undergo any event, only two patients seroconverted HBsAg and a total of 20 patients were lost to follow-up. HBsAg, hepatitis B surface antigen; antiHDV, antibodies against hepatitis delta virus; HIV, human immunodeficiency virus; HCC, hepatocellular carcinoma; OLT, orthotropic liver transplantation.

Mentions: Only patients with detectable HBsAg and either anti-HDV antibodies (anti-HDV Ab) or HDV-RNA for more than 6 months were included. Patients with undetectable HDV-RNA were considered to have chronic hepatitis delta if they repeatedly showed biochemical signs of hepatitis (e.g. transaminases increased 1.5-fold above the upper limit of normal ULN) in the absence of significant HBV replication. Patients were required to have an available follow-up of at least 18 months with a minimum of three visits at our centre and no longer than 4 years between consecutive visits. Those patients who had undergone an OLT before the first observation (baseline) or less than 18 months after baseline were excluded. Additional exclusion criteria were human immunodeficiency virus (HIV) co-infection, active alcohol abuse or drug addiction, evidence of metabolic, autoimmune or genetic liver disease and ongoing therapies that could interfere with either the liver function or the viral replication (e.g. chemotherapy). The system used for patient selection and inclusion is summarized in Fig. 1a.


Development and evaluation of a baseline-event-anticipation score for hepatitis delta.

Calle Serrano B, Großhennig A, Homs M, Heidrich B, Erhardt A, Deterding K, Jaroszewicz J, Bremer B, Koch A, Cornberg M, Manns MP, Buti M, Wedemeyer H - J. Viral Hepat. (2014)

(a) Patient recruitment, inclusion and exclusion criteria. Only 75 of 364 screened HBsAg-positive patients met all inclusion and none of the exclusion criteria. At baseline, 37 patients already had liver cirrhosis. (b) Long-term outcome of hepatitis D. Eighteen of 38 patients with chronic hepatitis at baseline developed liver cirrhosis in the 2–16 years they were followed up. Decompensation was the most frequent liver-related complication (32 of 56 patients with cirrhosis). Overall, eight patients developed hepatocellular carcinoma, six patients died (one of unknown cause) and 16 received a liver transplantation. Twenty-two patients did not undergo any event, only two patients seroconverted HBsAg and a total of 20 patients were lost to follow-up. HBsAg, hepatitis B surface antigen; antiHDV, antibodies against hepatitis delta virus; HIV, human immunodeficiency virus; HCC, hepatocellular carcinoma; OLT, orthotropic liver transplantation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4263246&req=5

fig01: (a) Patient recruitment, inclusion and exclusion criteria. Only 75 of 364 screened HBsAg-positive patients met all inclusion and none of the exclusion criteria. At baseline, 37 patients already had liver cirrhosis. (b) Long-term outcome of hepatitis D. Eighteen of 38 patients with chronic hepatitis at baseline developed liver cirrhosis in the 2–16 years they were followed up. Decompensation was the most frequent liver-related complication (32 of 56 patients with cirrhosis). Overall, eight patients developed hepatocellular carcinoma, six patients died (one of unknown cause) and 16 received a liver transplantation. Twenty-two patients did not undergo any event, only two patients seroconverted HBsAg and a total of 20 patients were lost to follow-up. HBsAg, hepatitis B surface antigen; antiHDV, antibodies against hepatitis delta virus; HIV, human immunodeficiency virus; HCC, hepatocellular carcinoma; OLT, orthotropic liver transplantation.
Mentions: Only patients with detectable HBsAg and either anti-HDV antibodies (anti-HDV Ab) or HDV-RNA for more than 6 months were included. Patients with undetectable HDV-RNA were considered to have chronic hepatitis delta if they repeatedly showed biochemical signs of hepatitis (e.g. transaminases increased 1.5-fold above the upper limit of normal ULN) in the absence of significant HBV replication. Patients were required to have an available follow-up of at least 18 months with a minimum of three visits at our centre and no longer than 4 years between consecutive visits. Those patients who had undergone an OLT before the first observation (baseline) or less than 18 months after baseline were excluded. Additional exclusion criteria were human immunodeficiency virus (HIV) co-infection, active alcohol abuse or drug addiction, evidence of metabolic, autoimmune or genetic liver disease and ongoing therapies that could interfere with either the liver function or the viral replication (e.g. chemotherapy). The system used for patient selection and inclusion is summarized in Fig. 1a.

Bottom Line: The baseline-event-anticipation score (BEA score) was developed based on variables associated with the development of liver-related clinical complications.Age, region of origin, presence of cirrhosis, albumin, INR, hyperbilirubinemia and thrombocytopenia were all associated with the development of an event in the training cohort.Delta hepatitis is associated with a very severe long-term outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany; German Center for Infection Research (DZIF), Partner Side HepNet Study-House, Hannover, Germany.

Show MeSH
Related in: MedlinePlus