TY - JOUR
T1 - A significant proportion of patients with chronic hepatitis B who are candidates for antiviral treatment are untreated
T2 - A region-wide survey in italy
AU - Giannini, Edoardo G.
AU - Torre, Francesco
AU - Basso, Monica
AU - Feasi, Marcello
AU - Boni, Silvia
AU - Grasso, Alessandro
AU - De Leo, Pasqualina
AU - Dodi, Ferdinando
AU - Marazzi, Maria Grazia
AU - Azzola, Emilio
AU - Bartolacci, Valentina
AU - Percario, Gianfranco
AU - Beltrame, Andrea
AU - Borro, Paolo
AU - Savarino, Vincenzo
AU - Picciotto, Antonino
PY - 2009/11
Y1 - 2009/11
N2 - 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.
AB - 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.
KW - Guidelines
KW - Hepatitis B virus
KW - Treatment
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U2 - 10.1097/MCG.0b013e31818e876f
DO - 10.1097/MCG.0b013e31818e876f
M3 - Article
C2 - 19318981
AN - SCOPUS:74949135174
VL - 43
SP - 1001
EP - 1007
JO - Journal of Clinical Gastroenterology
JF - Journal of Clinical Gastroenterology
SN - 0192-0790
IS - 10
ER -