A significant proportion of patients with chronic hepatitis B who are candidates for antiviral treatment are untreated: A region-wide survey in italy

Edoardo G. Giannini, Francesco Torre, Monica Basso, Marcello Feasi, Silvia Boni, Alessandro Grasso, Pasqualina De Leo, Ferdinando Dodi, Maria Grazia Marazzi, Emilio Azzola, Valentina Bartolacci, Gianfranco Percario, Andrea Beltrame, Paolo Borro, Vincenzo Savarino, Antonino Picciotto

Research output: Contribution to journalArticle

Abstract

Background: Between 350 and 400 million people worldwide have chronic hepatitis B virus (HBV) infection, and in Italy this figure is 1% to 2% in the general population. In clinical practice, however, it is not known how many patients chronically infected by HBV and eligible for antiviral therapy are not treated. Aim: To characterize the clinical picture of untreated HBV patients, and to assess whether current experts' recommendations for treatment are actually applied. Methods: We evaluated 362 patients chronically infected by HBV alone who were followed for at least 1 year at tertiary referral centers in Liguria region, Italy. Patients' data were evaluated on the basis of the Panel of Experts algorithm for the management of HBV [ie, HBV DNA levels ≥ 20,000 IU/mL in hepatitis B e antigen (HBeAg)-positive patients, HBV DNA levels ≥ 2000 IU/mL in HBeAg-negative patients, and evidence of biochemical and/or histologic activity of disease in both groups]. Results: One-hundred and sixteen viremic chronic hepatitis B disease patients were not on antiviral therapy (33 HBeAg positive, 83 HBeAg negative). Serum HBV DNA was ≥ 20,000 IU/mL and ≥ 2000 IU/mL in 32 HBeAg-positive and 54 HBeAg-negative patients, respectively, and disease was present in 59 of these 86 patients. Treatment was not indicated in 10 of 59 patients, and had been planned in 8 (4 HBeAg positive), thus 84% potential treatment candidates (41 of 49 patients) were not treated. Conclusions: Evaluation of a large series of patients chronically infected by HBV alone identified a significant proportion of patients who are actually untreated despite being potential candidates for antiviral therapy.

Original languageEnglish
Pages (from-to)1001-1007
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume43
Issue number10
DOIs
Publication statusPublished - Nov 2009

Keywords

  • Guidelines
  • Hepatitis B virus
  • Treatment

ASJC Scopus subject areas

  • Gastroenterology

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    Giannini, E. G., Torre, F., Basso, M., Feasi, M., Boni, S., Grasso, A., De Leo, P., Dodi, F., Marazzi, M. G., Azzola, E., Bartolacci, V., Percario, G., Beltrame, A., Borro, P., Savarino, V., & Picciotto, A. (2009). A significant proportion of patients with chronic hepatitis B who are candidates for antiviral treatment are untreated: A region-wide survey in italy. Journal of Clinical Gastroenterology, 43(10), 1001-1007. https://doi.org/10.1097/MCG.0b013e31818e876f