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.
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Data di pubblicazione: | 2016 | |
Titolo: | Missed treatment in an Italian HBV infected patients cohort: HBV RER. | |
Autori: | Ferrari, C.; Giuberti, T.; Villa, E.; Andreone, P.; Pietrangelo, A.; Abbati, G.; Magnani, G.; Massari, M.; Verucchi, G.; Cancellieri, C.; Ricca Rosellini, S.; Levantesi, F.; Mazzella, G.; Sacchini, D.; Fornaciari, G.; Mussini, C.; Borghi, V.; Foschi, F.; Carradori, S.D.; Contini, C.; Ballardini, G.; Macchia, S.; Boccia, S.; Vandelli, C.; Bassi, P.; Zanotti, M.; Loria, P.; Sbolli, G.; Fornari, F.; di Maira, P.V.; Bellentani, S.; Arlotti, M.; Grosso, C.; Bolondi, G.; Pazzi, P.; Mazzocchi, A.; Govoni, A.; Fusaroli, P.; Giacomoni, P.L.; Lenzi, M.; Pedretti, G. | |
Rivista: | DIGESTIVE AND LIVER DISEASE | |
Parole Chiave: | HBV; Hepatitis B treatment; Liver fibrosis | |
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. | |
Digital Object Identifier (DOI): | 10.1016/j.dld.2016.07.016 | |
Handle: | http://hdl.handle.net/11392/2353553 | |
Appare nelle tipologie: | 03.1 Articolo su rivista |