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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.
SUBMITTER: Gillespie IA
PROVIDER: S-EPMC10651815 | biostudies-literature | 2023 Nov
REPOSITORIES: biostudies-literature
Gillespie Iain A IA Barnes Eleanor E Wong Ian C K ICK Matthews Philippa C PC Cooke Graham S GS Tipple Craig C Elston Robert C RC Liu Yunhao Y Smith David A DA Wang Tingyan T Davies Jim J Várnai Kinga A KA Freeman Oliver O Man Kenneth K C KKC Lau Wallis C Y WCY Glampson Ben B Meng Xing X Morais Eleonora E Liu Sen S Mercuri Luca L Boxall Naomi N Jenner Sarah S Kendrick Stuart S Dong Jane J Theodore Dickens D
Infectious diseases and therapy 20230711 11
<h4>Introduction</h4>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.<h4>Methods</h4>This retrospective cross-sectional post hoc analysis of real-world data used four large electronic databases ...[more]