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Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
Characteristics of patients with chronic hepatitis B infection in China: A retrospective claims database study
Xing Meng1,2, Iain A Gillespie3, Jane Dong1
1GSK, Institute for Infectious Diseases and Public Health, Beijing, China.
Insights
In China, 90 million people have chronic hepatitis B (CHB). Despite this, only two-thirds of CHB patients received antiviral treatment, highlighting a significant gap in care.
Area of Science:
- Hepatology
- Public Health
- Health Services Research
Background:
- Chronic hepatitis B (CHB) poses a significant public health challenge in China, affecting approximately 90 million individuals.
- There are unmet clinical needs in managing CHB, necessitating an evaluation of current patient demographics, disease progression, and treatment patterns.
Purpose of the Study:
- To evaluate the demographics, clinical characteristics, disease progression, and treatment management of patients with CHB in China.
- To assess healthcare costs and utilization associated with CHB, considering factors like cirrhosis and hospital tier.
- To determine the proportion of CHB patients receiving appropriate antiviral therapy.
Main Methods:
- Retrospective, observational study using anonymized national administrative claims data from the China Health Insurance Research Association (2016).
- Patient identification via ICD-10 codes (B18.0, B18.1) and keyword searches for CHB/HBV and treatments (nucleos(t)ide analogues).
- Analysis of demographics, clinical characteristics, treatment prescription rates, healthcare costs, and utilization stratified by cirrhosis presence and hospital tier.
Main Results:
- The majority of CHB patients were male, aged 25-65, from East China, with employee health insurance.
- Cirrhosis was prevalent (16.20%), associated with male sex, older age, HCV coinfection, and increased healthcare utilization and costs.
- Only two-thirds of patients were prescribed antiviral therapy, predominantly nucleos(t)ide analogues, with Tier III hospitals seeing more complex cases.
Conclusions:
- A substantial proportion of CHB patients in China, particularly those with cirrhosis, face significant healthcare demands and costs.
- There is a critical need to improve access to and utilization of evidence-based antiviral treatments for CHB in China.
- Healthcare resource allocation and patient management strategies require optimization to address the unmet needs in CHB care.
Abstract:
Chronic hepatitis B (CHB) infection affects approximately 90 million people in China, where there are profoundly unmet clinical and public health needs. This study evaluated patient demographics, disease progression, and treatment management using national administrative claims data. This retrospective, observational study used anonymized data from the China Health Insurance Research Association claims database (January 1-December 31, 2016); data that could not be validated, or from duplicate entries, were excluded. Patients were identified using the International Classification of Diseases, 10th Revision diagnostic code for CHB (B18.0 and B18.1), using keyword searches for "CHB or HBV" and free-text descriptions of CHB treatments including nucleos(t)ide analogues. Primary objectives included evaluation of: demographics and clinical characteristics of patients with CHB, overall and by presence or absence of cirrhosis and hospital tier; proportion of patients prescribed CHB treatment; and healthcare costs and utilization overall and by presence or absence of cirrhosis and hospital tier. Most identified patients with CHB were male, aged 25 to 65 years, resided in East China, and had employee health insurance. Cirrhosis was common (16.20%) and associated with male preponderance, older age, hepatitis C virus coinfection, and higher hospital care demands and costs. The most frequently visited hospitals were Tier III; patients visiting Tier III generally required more hospital care compared with those visiting Tier I/II hospitals. Only two-thirds of patients were prescribed antiviral therapy for CHB (most commonly nucleos(t)ide analogues). Results from this study highlight a substantial need to improve access to appropriate CHB treatment in China.
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