ICBAS Abel Salazar Biomedical Institute, University of Porto, Porto, Portugal.
J Med Virol. 2011 Jan;83(1):71-7. doi: 10.1002/jmv.21939.
The prevalence of infection with hepatitis B virus in Portugal is around 1% of the population; 20-30% of those infected typically develop cirrhosis. The study focuses on the epidemiological profile of patients with hepatitis B infection and liver damage, in particular, cirrhosis. Of the 358 individuals that comprised the study, a liver biopsy was performed in 249 to identify the presence of cirrhosis. Cirrhosis was observed in 59 patients (23.7%) The Child-Pugh classification was used to assess the prognosis of cirrhosis: 3 out of the 59 patients were classified as Child-Pugh grade C, the most severe, 17 (28.8%) as grade B, and 39 (66.2%) as grade A. Patients classified as grade B were older, drank more, and showed higher levels of AST and alkaline phosphatase when compared with individuals classified as grade A. Genotypes A and D were predominant, and no significant differences with respect to genotype distribution were observed. Analysis of the hematological parameters showed that patients classified as Child's grade B had lower levels of platelets and higher levels of prothrombin time than those classified as Child's grade A. The profile of the patients with cirrhosis, including an extended number of individual characteristics, provides useful information, however, only a prospective study could evaluate definitively if liver disease is influenced by these factors. Future studies would benefit from the analysis of the impact of genotypes on liver disease, particularly genotypes A and D, the most predominant genotypes in northern Portugal.
葡萄牙乙型肝炎病毒感染的流行率约为人口的 1%;感染人群中有 20-30%通常会发展为肝硬化。本研究主要关注乙型肝炎感染和肝损伤患者的流行病学特征,特别是肝硬化。在 358 名研究对象中,有 249 名进行了肝活检以确定是否存在肝硬化。59 名患者(23.7%)观察到肝硬化。采用Child-Pugh 分级评估肝硬化的预后:59 名患者中,有 3 名(33.3%)被归类为 Child-Pugh 分级 C,即最严重的等级,17 名(28.8%)被归类为 B 级,39 名(66.2%)为 A 级。与 A 级患者相比,B 级患者年龄更大,饮酒更多,AST 和碱性磷酸酶水平更高。基因型 A 和 D 占主导地位,且基因型分布无显著差异。对血液参数的分析表明,与 A 级患者相比,B 级患者的血小板水平较低,凝血酶原时间较长。肝硬化患者的特征分析,包括许多个体特征,提供了有用的信息,但只有前瞻性研究才能明确评估这些因素是否影响肝病。未来的研究将受益于分析基因型对肝脏疾病的影响,特别是在葡萄牙北部占主导地位的基因型 A 和 D。