The Association between the Progression of Chronic Hepatitis B and Non-virus Factors: Observational Studies of Hospitalized Chinese Patients Público

Abstract

Objective: The aim of this study was to examine the association between the changes in paired liver biopsies and nutritional status, sleep status, alcohol consumption, and antiviral therapy.

Methods: Data were collected from the medical records of 190 hepatitis B patients in the 302 Military Hospital, Beijing, China, who had two liver biopsies between January 1999 and December 2012. Univariate analysis and multivariate logistic analysis were conducted.

Results: 69 patients (36.3%) had improvements in fibrosis stage and 73 (38.4%) had improvements in inflammation grade. Drinking alcohol (OR=0.35, 95%CI 0.10-1.20, p=0.09) was a harmful factor for the progression of fibrosis. Nutritional status, sleep status, and antiviral therapy were not statistically associated with the improvement in fibrosis stage. In addition, good nutritional status (OR 3.15, 95%CI 1.43-6.96, p<0.01) and taking adefovir (OR 3.97, 95%CI 1.25-12.57, p=0.05) were significantly associated with the improvement in inflammation grade.

Conclusion: This study evaluated the risk factors for the progression of liver damage and found that alcohol consumption had a significant impact on the deterioration of fibrosis. Nutritional status and antiviral therapy were significantly associated with the improvement in inflammation grade. No significant effect was associated with sleep status. The association between the various therapeutic interventions and the serological markers of virological clearance was not evaluated. Without serological information, it is difficult to make any firm conclusions. Further study will take into account whether treatment resulted in the clearance of hepatitis B infection.

Table of Contents

Table of Contents

BACKGROUND........................................................................................................ 5

MANUSCRIPT.......................................................................................................... 8

TITLE.................................................................................................................... 8

AUTHORS.............................................................................................................. 8

AFFILIATIONS........................................................................................................ 8

ABSTRACT............................................................................................................. 9

INTRODUCTION..................................................................................................... 11

METHODS..............................................................................................................13

RESULTS.............................................................................................................. 18

DISCUSSION......................................................................................................... 22

REFERENCES......................................................................................................... 27

TABLES................................................................................................................. 33

FIGURES............................................................................................................... 43

SUMMARY............................................................................................................... 45

APPENDIX............................................................................................................... 46

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Palabra Clave	epidemiology hepatitis B virus public health antiviral therapy chronic hepatitis B
Committee Chair / Thesis Advisor	Spaulding, Anne C, Emory University
Partnering Agencies	Hospital or other health care provider

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