Hepatitis B virus treatment rates still low among eligible patients

Administration rates of antiviral therapy remain low among treatment-eligible patients with chronic hepatitis B virus (CHB) and among CHB patients without human immunodeficiency virus (HIV), reveals a recent study.

“Timely initiation of antiviral therapy in CHB reduces risk of disease progression,” the authors said.

Adults with CHB from 2010 to 2018 across four large safety-net health systems in the US were retrospectively evaluated in this study. CHB was identified using the ICD-9/10 diagnosis coding and confirmed with laboratory data. The American Association for the Study of Liver Diseases (AASLD) guidelines were used to determine treatment eligibility.

The authors then compared CHB treatment rates among treatment-eligible patients using χ² testing, Kaplan Meier methods, and log-rank testing. They also determined the independent predictors of receiving treatment among participants using adjusted multivariate Cox proportional hazards models.

A total of 5,157 CHB patients (54.7 percent male, 34.6 percent African American, 22.3 percent Asian) were identified, of whom 46.8 percent were treatment-eligible during the study period. CHB treatment rates were 48.4 percent overall and 37.3 percent among those without HIV.

Female patients (odds ratio [OR], 0.40, 95 percent confidence interval [CI], 0.33‒0.49; p<0.001) and those aged ≥65 years (OR, 0.68, 95 percent CI, 0.51‒0.92; p=0.012) were significantly less likely to receive treatment than males and those aged <45 years, respectively.

On the other hand, African Americans and Asians, CHB patients with indigent care, and non-English speaking individuals had significantly higher likelihood of treatment than non-Hispanic Whites, those with commercial insurance, and English-speaking patients, respectively.

“Improving CHB treatment rates among treatment-eligible patients represents ‘low hanging fruit’, given the clear benefits of antiviral therapy in mitigating disease progression,” the authors said.