Titre
Demographics and outcomes of hepatitis B and D: a 10-year retrospective analysis in a Swiss tertiary referral center
Type
thèse de doctorat
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
Vieira Barbosa, Joana Sofia
Auteure/Auteur
Directrices/directeurs
Moradpour, Darius
Directeur⸱rice
Fraga, Montserrat
Codirecteur⸱rice
Liens vers les personnes
Liens vers les unités
Faculté
Université de Lausanne, Faculté de biologie et médecine
Statut éditorial
Accepté
Date de publication
2021
Langue
anglais
Résumé
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.
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.
PID Serval
serval:BIB_E6CA05250B50
Date de création
2021-11-03T11:18:16.621Z
Date de création dans IRIS
2025-05-21T06:27:52Z
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Nom
thèse-OK.pdf
Version du manuscrit
imprimatur
Taille
822.33 KB
Format
Adobe PDF
PID Serval
serval:BIB_E6CA05250B50.P001
URN
urn:nbn:ch:serval-BIB_E6CA05250B504
Somme de contrôle
(MD5):62dd3508ab51ab98693a913f6ac654ab