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Published on: December 15, 2023
Increasing Age and Nonliver Comorbidities in Patients with Chronic Hepatitis B in Taiwan: A Nationwide
Cheng-Hao Tseng1,2, Yao-Chun Hsu1,2,3, Hsiu J Ho4
1Division of Gastroenterology and Hepatology, E-DA Cancer Hospital/I-Shou University, Kaohsiung, Taiwan.
Insights
The chronic hepatitis B (CHB) population in Taiwan is aging, experiencing a rise in non-liver health issues and mortality. This highlights the need for enhanced monitoring and management strategies for CHB patients.
Area of Science:
- Hepatology
- Public Health
- Epidemiology
Background:
- Chronic hepatitis B (CHB) is highly prevalent in Taiwan.
- US data indicates an aging CHB population.
- The burden of non-liver comorbidities in Taiwanese CHB patients requires characterization.
Purpose of the Study:
- To examine demographic shifts in Taiwan's CHB population from 2001 to 2011.
- To assess the prevalence of non-liver comorbidities and medication use in CHB patients over a decade.
- To compare comorbidity profiles and outcomes between CHB patients and controls.
Main Methods:
- Retrospective analysis of the Taiwan National Health Insurance Research Database (NHIRD).
- Inclusion of adult CHB patients diagnosed in 2001, 2006, and 2011.
- Comparison with non-CHB controls from the Longitudinal Health Insurance Database 2000 (LHID2000).
Main Results:
- The CHB population aged significantly, with mean age increasing from 45.4 to 52.3 years.
- Prevalence of comorbidities (diabetes, hypertension, stroke, CKD, fractures) and medication use increased significantly.
- CHB patients were older and had more metabolic/cardiovascular comorbidities than controls, with rising non-liver mortality.
Conclusions:
- Taiwan's CHB population is aging, with an increasing burden of non-liver comorbidities.
- Non-liver mortality among CHB patients has risen over the study period.
- Findings emphasize the need for improved monitoring and management of CHB patients' non-liver health.
Background:
Data from the USA suggest that chronic hepatitis B (CHB) patients have aged in the past decade. However, the burden of nonliver comorbidities has not been well characterized in Taiwan, where CHB is very prevalent.
Aim:
Our study examined this issue as it presented between 2001 and 2011 in Taiwan.
Methods:
This study identified adult patients (≥18 years) who were diagnosed with CHB in 2001, 2006, and 2011, from the Taiwan National Health Insurance Research Database (NHIRD). Changes in demographic characteristics, prevalence of nonliver comorbidities, and medication usage over the decade were examined. Non-CHB controls were adults without CHB diagnosis from the Longitudinal Health Insurance Database 2000 (LHID2000).
Results:
A total of 102,158, 252,809, and 338,200 eligible patients were identified in 2001, 2006, and 2011, respectively. The mean age significantly advanced from 45.4 to 52.3 years over the decade (p < 0.001). The prevalence of comorbidities, including diabetes mellitus, hypertension, stroke, chronic kidney disease, and bone fracture, significantly increased between 2001 and 2011 (all p < 0.001), as so were medication usage (all p < 0.001). Moreover, within each study period, compared to non-CHB controls, CHB patients were also older and more likely to have metabolic and cardiovascular comorbidities (all p < 0.001). In addition, the annual nonliver mortality in the CHB population significantly increased from 2001 to 2011.
Conclusions:
Over a decade, the CHB population in Taiwan has aged with a higher nonliver comorbidity burden and increasing nonliver mortality. These findings may provide information to care providers in the monitoring and management of CHB patients.
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