Abstract
Treatment options for chronic hepatitis B (CHB) are pegylated interferon (Peg-IFN) in minimal/mild liver fibrosis and nucleot(s)ide analogues (NUC) in more advanced disease. Since little is known about their use in daily clinical practice, we conducted a multicentre prospective study to investigate treatment regimens applied to naïve CHB patients in real life. HBV-RER is an observational multicentre Italian network that collect clinic and virologic data of patients with CHB. Among the 2527 CHB patients seen during the study period (2009-2012), 502 patients started a first line antiviral treatment. Liver biopsy was performed in 30.9% of the patients, with high levels of fibrosis being detected in 19.4% of them. In 216 patients (43%) Peg-IFN was used as first-line therapy while the remaining patients started NUC therapy (entecavir and tenofovir in 75%, lamivudine in 15%, telbivudine and adefovir 10%). By multivariate logistic regression, an age under 40 (OR 0.92, 95%IC 0.90-0.94; p<0.001) and the execution of liver biopsy (OR 3.83; 95%IQR 1.76-8.36; p<0.001) were the only determinants of choice between Peg-IFN vs NUC. Peg-IFN was expected to be used in first-line treatment for CHB in 70% of the patients based on Italian recommendations, but a much lower proportion of patients were actually treated with Peg-IFN with a limited use of the biopsy. Thus, in daily clinical practice physicians prefer to use NUCs, presumably because of their optimal tolerability and anti-viral efficacy, even if they frequently require life-long treatment as opposed to the short duration of Peg-IFN.
| Original language | English |
|---|---|
| Pages (from-to) | 150-157 |
| Number of pages | 8 |
| Journal | Infezioni in Medicina |
| Volume | 25 |
| Issue number | 2 |
| Publication status | Published - 2017 |
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Keywords
- Chronic hepatitis B
- HBV
- Pegylated interferon
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases
Cite this
What to start with in first line treatment of chronic hepatitis B patients : An Italian multicentre observational cohort, HBV-RER study group. / Cuomo, Gianluca; Borghi, Vanni; Giuberti, Tiziana; Andreone, Pietro; Massari, Marco; Villa, Erica; Pietrangelo, Antonello; Verucchi, Gabriella; Levantesi, Fabio; Ferrari, Carlo.
In: Infezioni in Medicina, Vol. 25, No. 2, 2017, p. 150-157.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - What to start with in first line treatment of chronic hepatitis B patients
T2 - An Italian multicentre observational cohort, HBV-RER study group
AU - Cuomo, Gianluca
AU - Borghi, Vanni
AU - Giuberti, Tiziana
AU - Andreone, Pietro
AU - Massari, Marco
AU - Villa, Erica
AU - Pietrangelo, Antonello
AU - Verucchi, Gabriella
AU - Levantesi, Fabio
AU - Ferrari, Carlo
PY - 2017
Y1 - 2017
N2 - Treatment options for chronic hepatitis B (CHB) are pegylated interferon (Peg-IFN) in minimal/mild liver fibrosis and nucleot(s)ide analogues (NUC) in more advanced disease. Since little is known about their use in daily clinical practice, we conducted a multicentre prospective study to investigate treatment regimens applied to naïve CHB patients in real life. HBV-RER is an observational multicentre Italian network that collect clinic and virologic data of patients with CHB. Among the 2527 CHB patients seen during the study period (2009-2012), 502 patients started a first line antiviral treatment. Liver biopsy was performed in 30.9% of the patients, with high levels of fibrosis being detected in 19.4% of them. In 216 patients (43%) Peg-IFN was used as first-line therapy while the remaining patients started NUC therapy (entecavir and tenofovir in 75%, lamivudine in 15%, telbivudine and adefovir 10%). By multivariate logistic regression, an age under 40 (OR 0.92, 95%IC 0.90-0.94; p<0.001) and the execution of liver biopsy (OR 3.83; 95%IQR 1.76-8.36; p<0.001) were the only determinants of choice between Peg-IFN vs NUC. Peg-IFN was expected to be used in first-line treatment for CHB in 70% of the patients based on Italian recommendations, but a much lower proportion of patients were actually treated with Peg-IFN with a limited use of the biopsy. Thus, in daily clinical practice physicians prefer to use NUCs, presumably because of their optimal tolerability and anti-viral efficacy, even if they frequently require life-long treatment as opposed to the short duration of Peg-IFN.
AB - Treatment options for chronic hepatitis B (CHB) are pegylated interferon (Peg-IFN) in minimal/mild liver fibrosis and nucleot(s)ide analogues (NUC) in more advanced disease. Since little is known about their use in daily clinical practice, we conducted a multicentre prospective study to investigate treatment regimens applied to naïve CHB patients in real life. HBV-RER is an observational multicentre Italian network that collect clinic and virologic data of patients with CHB. Among the 2527 CHB patients seen during the study period (2009-2012), 502 patients started a first line antiviral treatment. Liver biopsy was performed in 30.9% of the patients, with high levels of fibrosis being detected in 19.4% of them. In 216 patients (43%) Peg-IFN was used as first-line therapy while the remaining patients started NUC therapy (entecavir and tenofovir in 75%, lamivudine in 15%, telbivudine and adefovir 10%). By multivariate logistic regression, an age under 40 (OR 0.92, 95%IC 0.90-0.94; p<0.001) and the execution of liver biopsy (OR 3.83; 95%IQR 1.76-8.36; p<0.001) were the only determinants of choice between Peg-IFN vs NUC. Peg-IFN was expected to be used in first-line treatment for CHB in 70% of the patients based on Italian recommendations, but a much lower proportion of patients were actually treated with Peg-IFN with a limited use of the biopsy. Thus, in daily clinical practice physicians prefer to use NUCs, presumably because of their optimal tolerability and anti-viral efficacy, even if they frequently require life-long treatment as opposed to the short duration of Peg-IFN.
KW - Chronic hepatitis B
KW - HBV
KW - Pegylated interferon
UR - http://www.scopus.com/inward/record.url?scp=85020916505&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85020916505&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:85020916505
VL - 25
SP - 150
EP - 157
JO - Infezioni in Medicina
JF - Infezioni in Medicina
SN - 1124-9390
IS - 2
ER -