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Survival in Chronic Hepatitis B: An Analysis of 379 Patients

JED I. WEISSBERG, M.D.; LJUDEVIT L. ANDRES, M.D.; COLEMAN I. SMITH, M.D.; SHEILA WEICK, R.N.; JOANNE E. NICHOLS, R.N.; GABRIEL GARCIA, M.D.; WILLIAM S. ROBINSON, M.D.; THOMAS C. MERIGAN, M.D.; and PETER B. GREGORY, M.D.
[+] Article and Author Information

Grant support: by a contract from the National Institute of Allergy and Infectious Diseases (AI 42527) and a grant from the John A. Hartford Foundation, Inc. (#76273).

This work was presented in part on 7 November 1981 at the meeting of the American Association for the Study of Liver Diseases and was published in abstract form in Hepatology (1981;1:548).

▸Requests for reprints should be addressed to Peter B. Gregory, M.D.; Division of Gastroenterology, Room S069, Stanford University Medical Center; Stanford, CA 94305.


Stanford, California


©1984 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1984;101(5):613-616. doi:10.7326/0003-4819-101-5-613
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Survival data from 379 patients with chronic hepatitis B were analyzed to determine life expectancy for the patient from the time of first contact. One hundred twenty-one patients had chronic persistent hepatitis, 128 had chronic active hepatitis, and 130 had chronic active hepatitis with cirrhosis. The frequency of symptoms (p < 0.001), stigmata of chronic liver disease (p < 0.001), and liver function test abnormalities (p < 0.001) increased as the histologic features worsened, whereas the percentage of patients with circulating hepatitis B DNA polymerase declined (p < 0.001). Women were uncommon in our series and had less severe disease than men (p < 0.02). Fifty-one patients had died by the time of this analysis. The estimated 5-year survival rates were 97% for patients with chronic persistent hepatitis, 86% for those with chronic active hepatitis, and 55% for those with chronic active hepatitis with cirrhosis. The usual cause of death was liver failure and its sequelae. A multivariate analysis found age of 40 years or more, total bilirubin level of 1.5 mg/dL or more, ascites, and spider nevi to be factors that identified patients at a higher risk of death. The prognosis for patients with chronic hepatitis B is similar to that for patients with chronic hepatitis of other causes.

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