What to start with in first line treatment of chronic hepatitis B patients: An Italian multicentre observational cohort, HBV-RER study group

Gianluca Cuomo, Vanni Borghi, Tiziana Giuberti, Pietro Andreone, Marco Massari, Erica Villa, Antonello Pietrangelo, Gabriella Verucchi, Fabio Levantesi, Carlo Ferrari

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)150-157
Number of pages8
JournalInfezioni in Medicina
Volume25
Issue number2
Publication statusPublished - 2017

Fingerprint

Chronic Hepatitis B
Interferons
Therapeutics
Tenofovir
Biopsy
Lamivudine
Liver
Liver Cirrhosis
Multicenter Studies
Antiviral Agents
Fibrosis
Logistic Models
Prospective Studies
Physicians

Keywords

  • Chronic hepatitis B
  • HBV
  • Pegylated interferon

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Cuomo, G., Borghi, V., Giuberti, T., Andreone, P., Massari, M., Villa, E., ... Ferrari, C. (2017). What to start with in first line treatment of chronic hepatitis B patients: An Italian multicentre observational cohort, HBV-RER study group. Infezioni in Medicina, 25(2), 150-157.

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 journalArticle

Cuomo, G, Borghi, V, Giuberti, T, Andreone, P, Massari, M, Villa, E, Pietrangelo, A, Verucchi, G, Levantesi, F & Ferrari, C 2017, 'What to start with in first line treatment of chronic hepatitis B patients: An Italian multicentre observational cohort, HBV-RER study group', Infezioni in Medicina, vol. 25, no. 2, pp. 150-157.
Cuomo, Gianluca ; Borghi, Vanni ; Giuberti, Tiziana ; Andreone, Pietro ; Massari, Marco ; Villa, Erica ; Pietrangelo, Antonello ; Verucchi, Gabriella ; Levantesi, Fabio ; Ferrari, Carlo. / What to start with in first line treatment of chronic hepatitis B patients : An Italian multicentre observational cohort, HBV-RER study group. In: Infezioni in Medicina. 2017 ; Vol. 25, No. 2. pp. 150-157.
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