Patient Biochemistry and Treatment Need in Chronic Hepatitis B Virus Infection Across Three Continents: Retrospective Cross-Sectional Cohort Studies

Autor: Iain A. Gillespie, Eleanor Barnes, Ian C. K. Wong, Philippa C. Matthews, Graham S. Cooke, Craig Tipple, Robert C. Elston, Yunhao Liu, David A. Smith, Tingyan Wang, Jim Davies, Kinga A. Várnai, Oliver Freeman, Kenneth K. C. Man, Wallis C. Y. Lau, Ben Glampson, Xing Meng, Eleonora Morais, Sen Liu, Luca Mercuri, Naomi Boxall, Sarah Jenner, Stuart Kendrick, Jane Dong, Dickens Theodore
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Infectious Diseases and Therapy, Vol 12, Iss 11, Pp 2513-2532 (2023)
Druh dokumentu: article
ISSN: 2193-8229
2193-6382
DOI: 10.1007/s40121-023-00824-y
Popis: Abstract Introduction Chronic hepatitis B virus (HBV) infection is associated with significant global morbidity and mortality. Low treatment rates are observed in patients living with HBV; the reasons for this are unclear. This study sought to describe patients’ demographic, clinical and biochemical characteristics across three continents and their associated treatment need. Methods This retrospective cross-sectional post hoc analysis of real-world data used four large electronic databases from the United States, United Kingdom and China (specifically Hong Kong and Fuzhou). Patients were identified by first evidence of chronic HBV infection in a given year (their index date) and characterized. An algorithm was designed and applied, wherein patients were categorized as treated, untreated but indicated for treatment and untreated and not indicated for treatment based on treatment status and demographic, clinical, biochemical and virological characteristics (age; evidence of fibrosis/cirrhosis; alanine aminotransferase [ALT] levels, HCV/HIV coinfection and HBV virology markers). Results In total, 12,614 US patients, 503 UK patients, 34,135 patients from Hong Kong and 21,614 from Fuzhou were included. Adults (99.4%) and males (59.0%) predominated. Overall, 34.5% of patients were treated at index (range 15.9–49.6%), with nucleos(t)ide analogue monotherapy most commonly prescribed. The proportion of untreated-but-indicated patients ranged from 12.9% in Hong Kong to 18.2% in the UK; almost two-thirds of these patients (range 61.3–66.7%) had evidence of fibrosis/cirrhosis. A quarter (25.3%) of untreated-but-indicated patients were aged ≥ 65 years. Conclusion This large real-world dataset demonstrates that chronic hepatitis B infection remains a global health concern; despite the availability of effective suppressive therapy, a considerable proportion of predominantly adult patients apparently indicated for treatment are currently untreated, including many patients with fibrosis/cirrhosis. Causes of disparity in treatment status warrant further investigation.
Databáze: Directory of Open Access Journals
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