For this study, researchers investigated the evaluation and treatment rates of patients from the REAL-B consortium, a global collaboration of experts from 25 study centers across nine countries who treat patients with HBV.
The authors wrote, “This was a cross-sectional study nested within our retrospective multinational clinical consortium (2000–2021). We determined the proportions of patients receiving adequate evaluation, meeting AASLD [American Association for the Study of Liver Diseases] treatment criteria, and initiating treatment at any time during the study period. We also identified factors associated with receiving adequate evaluation and treatment using multivariable logistic regression analyses.”
The researchers examined data from 12,566 treatment-naïve adult patients with HBV infection, with an average age of 47.1 years. Of these individuals, 41.7% were female, 96.1% were Asian, 49.6% were from Western regions, and 8.7% had cirrhosis. Overall, 73.3% (9,206 patients) received adequate evaluation. Key findings reveal that among sufficiently assessed patients, an estimated 32.6% (3,001) were treatment-eligible by international guidelines. Among those patients who were treatment-eligible, about 83.3% (2500) were treated, and significant gender disparities revealed that females were more likely to undergo adequate evaluation but were 50% less likely to initiate treatment when indicated. With regard to ethnic disparities, Asian patients from the West were about 40% to 50% less likely to undergo adequate evaluation or initiate antiviral treatments when indicated compared with Asian patients from the East.
The authors noted that these data highlight the need for augmented awareness among patients, care providers, and healthcare policymakers regarding the routes of transmission, the significance of screening and prevention, evaluation, the availability of effective and well-tolerated treatments, and the cost-effectiveness of treatment.
“Evaluation and treatment rates were suboptimal for patients with CHB in both the East and West, with significant sex and ethnic disparities. Improved linkage to care with linguistically competent and culturally sensitive approaches is needed,” the authors concluded.
The researchers noted, “In clinical practice, we continue to see patients with advanced liver disease due to HBV despite having vaccines for prevention and excellent oral therapy for those who are treatment eligible. Simplifying and broadening HBV management is crucial.”
Lead investigator Mindie H. Nguyen, MD, MAS, AGAF, FAASLD, Division of Gastroenterology and Hepatology, Stanford University Medical Center and Department of Epidemiology and Population Health, Stanford University School of Medicine, stated, “We conducted a large-scale study using a global cohort of patients with HBV, drawn from academic and referral practices, to identify patterns in treatment utilization. Our aim was to assist in developing more robust case-finding guidelines, which we believe should also be tailored for nonspecialist primary care providers and resource-limited settings. Our multinational real-world study of patients with chronic HBV revealed that rates of treatment evaluation and initiation remain below optimal levels, even among patients with cirrhosis and patients from referral practices.”
The authors of this study also noted that as the World Health Organization’s 2030 goal to eradicate viral hepatitis draws near, targeted outreach is essential to diminish the incidence of new infections and mortalities. The findings from this study provide clinicians and policymakers with robust data to enhance current guidelines, aiding in achieving this goal and enhancing patient outcomes.
The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.
