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Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
Characteristics, Treatment Patterns, and Clinical Outcomes of Chronic Hepatitis B Across 3 Continents: Retrospective
Iain A Gillespie1, K Arnold Chan2,3, Yunhao Liu4
1Epidemiology, Value Evidence and Outcomes, GSK, Gunnels Wood Road, Stevenage, UK. iain.a.gillespie@gsk.com.
Insights
Real-world data on chronic hepatitis B virus (HBV) infection show varying prevalence and low treatment rates across the US, Germany, and Taiwan. Long-term outcomes occurred in all populations, highlighting an unmet need for effective HBV treatments.
Area of Science:
- Hepatology
- Epidemiology
- Public Health
Background:
- Chronic hepatitis B virus (HBV) infection poses a significant global health burden.
- Robust, real-world epidemiological data on chronic HBV infection are limited.
- Understanding prevalence, characteristics, and outcomes is crucial for effective management.
Purpose of the Study:
- To describe the prevalence, patient characteristics, and treatment patterns of chronic HBV infection.
- To evaluate long-term clinical outcomes in patients with chronic HBV infection.
- To compare these aspects across the US, Germany, and Taiwan.
Main Methods:
- Retrospective cohort analysis of healthcare/insurance claims databases.
- Identification of chronic HBV infection using diagnostic codes (2010-2013).
- Description of demographics, clinical characteristics, healthcare utilization, treatment patterns, and long-term outcomes (to 2016).
Main Results:
- Prevalence varied: 0.10% (US), 0.17% (Germany), 2.39% (Taiwan).
- Higher HIV±HCV coinfection in US/Germany vs. Taiwan.
- Low treatment rates observed, particularly in Taiwan; nucleos(t)ide analogues were the primary treatment modality.
Conclusions:
- This study offers a contemporary, real-world, intercontinental overview of chronic HBV infection.
- Long-term sequelae were observed across all studied populations.
- Low treatment levels indicate a significant unmet need for effective HBV therapies or improved access.
Introduction:
The prevalence of chronic hepatitis B virus (HBV) infection is high in many countries; however, robust, real-world epidemiological data are lacking. This study describes the prevalence, characteristics, treatment patterns, and long-term clinical outcomes of patients with chronic HBV infection in the US, Germany, and Taiwan.
Methods:
This was a retrospective cohort analysis of three healthcare/insurance claims databases. Individuals were identified as patients with chronic HBV infection if their records contained HBV diagnostic codes from 1 January 2010 to 31 December 2012 (Germany and Taiwan) or 1 January 2013 (USA). Included patients were indexed on 1 January 2013. Patients' demographics, clinical characteristics, and healthcare utilisation were described. Treatment patterns and long-term clinical outcomes over follow-up (to 31 December 2016 or loss to follow-up) were estimated.
Results:
The prevalence of chronic HBV infection was 0.10%, 0.17%, and 2.39% in the US, Germany, and Taiwan respectively. Prevalence was very low in children, increased rapidly in adulthood, and peaked in 50- < 65 year olds before declining in the elderly. More US (16.6%) and German (15.4%) patients were HIV ± HCV coinfected than in Taiwan (4.1%). Baseline clinical characteristics and healthcare utilisation were broadly similar between countries. In total, 19.2%, 11.1%, and 5.9% of non-coinfected adult patients received treatment at index in the US, Germany, and Taiwan, respectively; most frequently with nucleos(t)ide analogue monotherapy (94.4%, 97.2%, 99.8% of treated patients, respectively) and rarely with interferons (0.27%, 1.63%, and 0.06%, respectively). Untreated Taiwanese patients were more likely to remain untreated than elsewhere, and treated Taiwanese patients were less likely to persist with therapy. Generally, the cumulative incidence of long-term clinical outcomes was lowest in Germany.
Conclusion:
This study provides a contemporary, real-world, intercontinental snapshot of chronic HBV infection. Long-term sequelae occurred in all populations, and treatment levels were low, suggesting an unmet need for (or access to) effective treatments.
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