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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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Chronic Hepatitis B in US Veterans.

Patrik Garren1, Marina Serper1,2,3

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Chronic Hepatitis B virus (HBV) affects 1% of veterans, with higher risks in co-infections. Adherence to recommended HBV care is suboptimal, highlighting a need for improved management strategies.

Keywords:
Care QualityCirrhosisHepatitis B EpidemiologyHepatitis B reactivationHepatitis DeltaHepatocellular Carcinoma

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Area of Science:

  • Hepatology and Infectious Diseases
  • Viral Hepatitis Research
  • Public Health Epidemiology

Background:

  • Chronic Hepatitis B virus (HBV) infection prevalence in the US veteran population.
  • Association of HBV with advanced liver disease in cases of co-infection with Hepatitis C virus (HCV), Human Immunodeficiency Virus (HIV), and delta hepatitis.
  • Understanding of HBV epidemiology and its impact on patient outcomes.

Purpose of the Study:

  • To review current data on chronic HBV epidemiology.
  • To examine challenges in special populations receiving immunosuppressive therapy and HCV direct-acting antiviral (DAA) treatment.
  • To describe HBV care delivery, adherence to guidelines, and access barriers.

Main Methods:

  • Literature review of recent studies on chronic HBV.
  • Analysis of epidemiological data within the veteran population.
  • Assessment of care delivery models and adherence metrics.

Main Results:

  • Chronic HBV affects up to 1% of veterans, exceeding general population rates.
  • HBV co-infection with HCV, HIV, or delta hepatitis is linked to more severe liver disease.
  • Significant HBV reactivation risk observed with anti-CD20 antibodies; low risk with HCV DAA therapy; no cases with anti-TNF therapy.
  • Adherence to guideline-recommended HBV care is suboptimal across various quality indicators.

Conclusions:

  • The Department of Veterans Affairs (VA) has contributed significant research on HBV epidemiology, outcomes, and care.
  • Prospective studies are needed to identify effective strategies for enhancing guideline-recommended HBV care.