Al-Naamani Khalid, Al-Harthi Rahma, Al-Busafi Said A, Al Zuhaibi Haifa, Al-Sinani Siham, Omer Heba, Rasool Wasif
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Armed Forces Hospital, Muscat, Oman.
Professional Competence Affairs, Oman Medical Specialty Board, Muscat, Oman.
Oman Med J. 2022 May 31;37(3):e384. doi: 10.5001/omj.2022.54. eCollection 2022 May.
An estimated 887 000 deaths were due to chronic hepatitis B (CHB) related complications in 2015 worldwide. Most of these deaths were related to decompensated liver cirrhosis and hepatocellular carcinoma (HCC). Oman is a country with an intermediate prevalence of CHB. The Hepatitis B vaccine was introduced in Oman in 1990, with a vaccine coverage rate of > 95% reported in 2005. Despite the association between CHB and liver cirrhosis and HCC, no available data from Oman demonstrates CHB-related liver cirrhosis. We sought to estimate the prevalence of CHB among patients with liver cirrhosis from Oman.
We conducted a retrospective chart review of patients diagnosed with liver cirrhosis at Sultan Qaboos University Hospital and Armed Forces Hospital between January 2006 and April 2013. All pediatric and adult patients with liver cirrhosis were included. We collected demographic data and liver cirrhosis investigations.
A total of 419 patients were included. Two-thirds of the patients were males. The median age was 59 years. Omani patients represented the majority (97.1%) of patients with cirrhosis. Diabetes mellitus was present in almost half of the patients, and 22.2% indicated alcohol consumption. Evidence of previous or current hepatitis B virus (HBV) infection was found in about half of the cohort (51.3%). Only 3.3% of CHB patients were positive for hepatitis B e-Antigen. HBV DNA was detected in 47 patients (21.9%), of which 20 patients had a high viral load > 2000 IU/ml. More than a third (36.7%) had positive hepatitis B surface antibody (anti-HBs), indicating immunity to HBV, and 27.1% was due to previous HBV infection, 5.2% was immune due to vaccination, and 3.7% had positive anti-HBs and unknown anti-HBc status. Negative anti-HBs was found in 34.1% of the cohort and 29.9% had unknown immunity status. HBV coinfection with HCV was found in 24.7% of HBV patients with cirrhosis.
Serological markers of CHB are common among liver cirrhosis patients in Oman. CHB related cirrhosis was more common in old age males than females (70.7% vs. 29.3%, respectively; < 0.010). Evidence of past or present HBV infection was found in > 50% of the patients.
2015年全球估计有88.7万人死于慢性乙型肝炎（CHB）相关并发症。这些死亡大多与失代偿期肝硬化和肝细胞癌（HCC）有关。阿曼是一个CHB中等流行率的国家。1990年阿曼引入了乙肝疫苗，2005年报告的疫苗接种率>95%。尽管CHB与肝硬化和HCC之间存在关联，但阿曼尚无数据表明存在CHB相关肝硬化。我们试图估计阿曼肝硬化患者中CHB的患病率。
我们对2006年1月至2013年4月在苏丹卡布斯大学医院和武装部队医院被诊断为肝硬化的患者进行了回顾性病历审查。纳入所有儿童和成人肝硬化患者。我们收集了人口统计学数据和肝硬化检查结果。
共纳入419例患者。三分之二的患者为男性。中位年龄为59岁。阿曼患者占肝硬化患者的大多数（97.1%）。近一半的患者患有糖尿病，22.2%的患者表明有饮酒史。在约一半的队列（51.3%）中发现了既往或当前乙肝病毒（HBV）感染的证据。只有3.3%的CHB患者乙肝e抗原呈阳性。47例患者（21.9%）检测到HBV DNA，其中20例患者病毒载量高>2000 IU/ml。超过三分之一（36.7%）的患者乙肝表面抗体（抗-HBs）呈阳性，表明对HBV有免疫力，27.1%是由于既往HBV感染，5.2%是由于接种疫苗产生免疫，3.7%的患者抗-HBs呈阳性且抗-HBc状态未知。34.1%的队列中抗-HBs呈阴性，29.9%的患者免疫状态未知。在24.7%的HBV肝硬化患者中发现HBV与HCV合并感染。
CHB的血清学标志物在阿曼肝硬化患者中很常见。CHB相关肝硬化在老年男性中比女性更常见（分别为70.7%和29.3%；<0.010）。超过50%的患者发现有既往或当前HBV感染的证据。
