Effect of the change in antiviral therapy indication in increasing the treatment rate of chronic hepatitis B
10.3969/j.issn.1001-5256.2022.06.011
- VernacularTitle:抗病毒治疗适应证变化对提高慢性乙型肝炎治疗率的影响
- Author:
Hao WANG
1
;
Shan SHAN
2
;
Hong YOU
2
;
Xiaoyuan XU
3
;
Lai WEI
4
;
Jinlin HOU
5
;
Hui ZHUANG
6
;
Yuanyuan KONG
1
;
Jidong JIA
2
Author Information
1. Department of Clinical Epidemiology and Evidence-based Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
2. Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
3. Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
4. Department of Hepatology, Beijing Tsinghua Changgung Hospital, Beijing 100044, China
5. Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
6. Department of Microbiology and Parasitology, Peking University Health Science Center, Beijing 100191, China
- Publication Type:Original Articles_Viral Hepatitis
- Keywords:
Hepatitis B, Chronic;
Antiviral Agents;
Indication
- From:
Journal of Clinical Hepatology
2022;38(6):1269-1274
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of the change in anti-hepatitis B virus (HBV) therapy indication on treatment rate and the features of the population requiring treatment. Methods The treatment-naïve patients with chronic hepatitis B (CHB) in the China Registry of Hepatitis B (CR-HepB) database were selected as subjects, and related demographic, virological, hematological, and biochemical data were collected. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results A total of 3640 treatment-naïve CHB patients were included in this study, among whom 64.4% were male, 68.7% had an age of 30-59 years, and 46.8% had an indeterminate clinical stage. According to the 2015 and 2019 editions of Guidelines for the prevention and treatment of chronic hepatitis B and the 2022 edition of expert consensus, the number of patients who had the indication for antiviral therapy was 625(17.2%), 1333(36.6%), and 2890(79.4%), respectively. The number of patients requiring treatment was increased by 1557 according to the 2022 edition of expert consensus, among whom 1424(91.5%) met the treatment threshold of alanine aminotransferase (ALT) > 30 U/L for male patients or ALT > 19 U/L for female patients. The additional patients requiring treatment according to the 2022 edition of expert consensus had significantly higher levels of ALT and HBV DNA and significantly lower scores of APRI and FIB-4 than the additional patients requiring treatment according to the 2019 edition of Guidelines (all P < 0.05). Conclusion The expansion of antiviral therapy indications for CHB may significantly increase the proportion of CHB patients receiving antiviral treatment and help mild CHB patients at the risk of disease progression to receive timely treatment and achieve the improvement in long-term prognosis.
