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

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...

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Published in:Digestive and liver disease 2016-11, Vol.48 (11), p.1346-1350
Main Authors: Cuomo, Gianluca, Borghi, Vanni, Andreone, Pietro, Massari, Marco, Villa, Erica, Pietrangelo, Antonello, Verucchi, Gabriella, Ferrari, Carlo
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Alanine Transaminase - blood
Antiviral Agents - therapeutic use
Databases, Factual
DNA, Viral - blood
Female
Gastroenterology and Hepatology
HBV
Healthcare Disparities - statistics & numerical data
Hepatitis B Surface Antigens - blood
Hepatitis B treatment
Hepatitis B virus - genetics
Hepatitis B, Chronic - drug therapy
Humans
Italy
Liver - pathology
Liver fibrosis
Logistic Models
Male
Middle Aged
Multivariate Analysis
Severity of Illness Index
Young Adult
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Summary: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-talian (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.
ISSN:1590-8658
1878-3562
DOI:10.1016/j.dld.2016.07.016