SURVIVAL ANALYSIS OF PATIENTS WITH CHRONIC HEPATITIS B AT THE FEDERAL MEDICAL CENTRE, NGURU
Abstract
Background: Hepatitis B Virus (HBV) infection remains a major cause of liver-related morbidity and mortality, particularly in sub-Saharan Africa (SSA). Despite the high prevalence of HBV in Nigeria, few studies have assessed the survival patterns of affected patients in the northern region.
Methods: This retrospective cohort study included 150 patients with confirmed chronic hepatitis B who received care at the Federal Medical Centre, Nguru, between January 2019 and December 2024. Survival time was calculated from diagnosis to death or censoring. Kaplan–Meier survival estimates and log-rank tests were used for univariate analysis. The effects of age, sex, liver biopsy results, AST and ALT enzyme levels, antiviral therapy, viral load, and comorbidities on patient survival were assessed using the Cox proportional hazards model.
Results: The model diagnostics confirmed that the proportional hazards assumption was not violated (p = 0.2278), and the model demonstrated strong predictive power with a Harrell’s C-statistic of 0.845. Age (HR ≈ 1.03, p = 0.043), advanced liver fibrosis or cirrhosis (HR ≈ 3.15, p = 0.024), and comorbid conditions such as HIV, diabetes, or hypertension (HR ≈ 4.11, p = 0.003) were associated with significantly increased hazard of death. Antiviral therapy, particularly tenofovir, was found to reduce the hazard by approximately 77% (HR ≈ 0.23, p < 0.001), demonstrating a strong protective effect. Gender and elevated AST levels showed weak but positive associations with increased hazard, though not strongly significant at the 5% level. The median survival time was 44 months (95% confidence interval [CI]: 41–53). Kaplan–Meier analysis demonstrated significantly poorer survival in patients with comorbidities and advanced liver disease.
Conclusion: Age, liver fibrosis, comorbidities, and antiviral therapy were the major determinants of survival among patients with chronic hepatitis B at the Federal Medical Centre, Nguru. This study highlights the importance of early diagnosis, routine fibrosis assessment, and timely initiation of antiviral therapy in improving the survival of patients with chronic hepatitis B in resource-constrained settings. The findings of this study provide valuable evidence for clinicians and policymakers aiming to improve hepatitis B management and reduce liver-related deaths in Northern Nigeria
Keywords:
Chronic Hepatitis B, Survival Analysis, Kaplan–Meier estimate, Cox Proportional Hazards model, Antiviral therapy (Tenofovir and Entecavir), Comorbidities, Federal Medical Centre, Nguru, NigeriaDownloads
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Copyright (c) 2025 Dr. Abubakar Muhammad Auwal, Dr. Saleh Ibrahim Musa , Ahmad Bala Doma
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