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Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study
BACKGROUND: Antiviral treatment for chronic hepatitis B (CHB) is largely unavailable in sub-Saharan Africa; hence, little is known about the prognosis after initiating treatment in African CHB patients. In this study we aimed to assess predictors of mortality in one of the largest CHB cohorts in sub...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521482/ https://www.ncbi.nlm.nih.gov/pubmed/31092203 http://dx.doi.org/10.1186/s12876-019-0993-1 |
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author | Desalegn, Hailemichael Aberra, Hanna Berhe, Nega Medhin, Girmay Mekasha, Bitsatab Gundersen, Svein Gunnar Johannessen, Asgeir |
author_facet | Desalegn, Hailemichael Aberra, Hanna Berhe, Nega Medhin, Girmay Mekasha, Bitsatab Gundersen, Svein Gunnar Johannessen, Asgeir |
author_sort | Desalegn, Hailemichael |
collection | PubMed |
description | BACKGROUND: Antiviral treatment for chronic hepatitis B (CHB) is largely unavailable in sub-Saharan Africa; hence, little is known about the prognosis after initiating treatment in African CHB patients. In this study we aimed to assess predictors of mortality in one of the largest CHB cohorts in sub-Saharan Africa. METHODS: Two-hundred-and-seventy-six CHB patients who started treatment with tenofovir disoproxil fumarate at a public hospital in Ethiopia between March 18, 2015, and August 1, 2017, were included in this analysis. Patients were followed up until October 1, 2017, and deaths were ascertained through hospital records and telephone interview with relatives. Decompensated cirrhosis was defined as current or past evidence of ascites, either by clinical examination or by ultrasonography. Cox proportional hazard models were used to identify independent predictors of mortality. RESULTS: Thirty-five patients (12.7%) died during follow-up, 33 of whom had decompensated cirrhosis at recruitment. The median duration from start of treatment to death was 110 days (interquartile range 26–276). The estimated survival was 90.3, 88.2 and 86.3% at 6, 12 and 24 months of follow-up, respectively. Independent predictors of mortality were decompensated cirrhosis (adjusted hazard ratio [AHR] 23.68; 95% CI 3.23–173.48; p = 0.002), body mass index < 18.5 kg/m2 (AHR 3.65; 95% CI 1.73–7.72; p = 0.001) and older age (per 1-year increment; AHR 1.06; 95% CI 1.02–1.10; p = 0.007). CONCLUSIONS: Decompensated cirrhosis, low body mass index and older age were independent predictors of mortality. Improved access to antiviral treatment and earlier initiation of therapy could improve the survival of African CHB patients. TRIAL REGISTRATION: NCT02344498 (ClinicalTrials.gov identifier). Registered 16 January 2015. |
format | Online Article Text |
id | pubmed-6521482 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-65214822019-05-23 Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study Desalegn, Hailemichael Aberra, Hanna Berhe, Nega Medhin, Girmay Mekasha, Bitsatab Gundersen, Svein Gunnar Johannessen, Asgeir BMC Gastroenterol Research Article BACKGROUND: Antiviral treatment for chronic hepatitis B (CHB) is largely unavailable in sub-Saharan Africa; hence, little is known about the prognosis after initiating treatment in African CHB patients. In this study we aimed to assess predictors of mortality in one of the largest CHB cohorts in sub-Saharan Africa. METHODS: Two-hundred-and-seventy-six CHB patients who started treatment with tenofovir disoproxil fumarate at a public hospital in Ethiopia between March 18, 2015, and August 1, 2017, were included in this analysis. Patients were followed up until October 1, 2017, and deaths were ascertained through hospital records and telephone interview with relatives. Decompensated cirrhosis was defined as current or past evidence of ascites, either by clinical examination or by ultrasonography. Cox proportional hazard models were used to identify independent predictors of mortality. RESULTS: Thirty-five patients (12.7%) died during follow-up, 33 of whom had decompensated cirrhosis at recruitment. The median duration from start of treatment to death was 110 days (interquartile range 26–276). The estimated survival was 90.3, 88.2 and 86.3% at 6, 12 and 24 months of follow-up, respectively. Independent predictors of mortality were decompensated cirrhosis (adjusted hazard ratio [AHR] 23.68; 95% CI 3.23–173.48; p = 0.002), body mass index < 18.5 kg/m2 (AHR 3.65; 95% CI 1.73–7.72; p = 0.001) and older age (per 1-year increment; AHR 1.06; 95% CI 1.02–1.10; p = 0.007). CONCLUSIONS: Decompensated cirrhosis, low body mass index and older age were independent predictors of mortality. Improved access to antiviral treatment and earlier initiation of therapy could improve the survival of African CHB patients. TRIAL REGISTRATION: NCT02344498 (ClinicalTrials.gov identifier). Registered 16 January 2015. BioMed Central 2019-05-15 /pmc/articles/PMC6521482/ /pubmed/31092203 http://dx.doi.org/10.1186/s12876-019-0993-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Desalegn, Hailemichael Aberra, Hanna Berhe, Nega Medhin, Girmay Mekasha, Bitsatab Gundersen, Svein Gunnar Johannessen, Asgeir Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study |
title | Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study |
title_full | Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study |
title_fullStr | Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study |
title_full_unstemmed | Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study |
title_short | Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study |
title_sort | predictors of mortality in patients under treatment for chronic hepatitis b in ethiopia: a prospective cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521482/ https://www.ncbi.nlm.nih.gov/pubmed/31092203 http://dx.doi.org/10.1186/s12876-019-0993-1 |
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