Missed treatment in an Italian HBV infected patients cohort: HBV RER

Dig Liver Dis. 2016 Nov;48(11):1346-1350. doi: 10.1016/j.dld.2016.07.016. Epub 2016 Jul 21.

Abstract

Background and aims: Very little is known about the access to treatment for Chronic Hepatitis B in the real clinical practice and the characteristics of the patients who do not receive antiviral therapy.

Methods: HBV-RER is an observational multicenter network that collected data of patients with HBV infection during a 3 years observational period (2009-2012).

Results: Among 2527 HBsAg positive patients, 1099 were never treated (NT); only 280 were included in the analysis due to different exclusion causes A minority was HBeAg-positive. The median age was 42. At liver biopsy most patients had Metavir score of F0-F1. Univariate analysis between 280 NT patients and the 290 naïve to treatment showed that NT patients were mostly female (P=0.002), not Italian (P=0.044), younger (P<0.001). Metavir score was lower in NT (P0.002), such as the Fib4 score (P<0.001). HBV DNA level was significantly higher in NT. At multivariate analysis, independent variables associated with no-treatment were younger age, female gender, Metavir score F0-F1, Fib4 lower than 1.6 and lower blood level of HBV-DNA.

Conclusions: There is a large number of patients eligible to treatment who do not receive it. A younger age and a less severe disease seem to be associated to deferral of treatment.

Keywords: HBV; Hepatitis B treatment; Liver fibrosis.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alanine Transaminase / blood
  • Antiviral Agents / therapeutic use*
  • DNA, Viral / blood
  • Databases, Factual
  • Female
  • Healthcare Disparities / statistics & numerical data*
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B virus / genetics
  • Hepatitis B, Chronic / drug therapy*
  • Humans
  • Italy
  • Liver / pathology
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Severity of Illness Index
  • Young Adult

Substances

  • Antiviral Agents
  • DNA, Viral
  • Hepatitis B Surface Antigens
  • Alanine Transaminase