Summary
Are newly diagnosed patients with HBV and HCV
infection different ?
Comparison between 2 prospective registries of the Belgian
Association for the Study of the Liver
Bénédicte De Vroey
1
, Christophe Moreno
2
, Wim Laleman
3
, Marc van Gossum
4
, Isabelle Colle
5
,
Chantal de Galocsy
6
, Philippe Langlet
7
, Geert Robaeys
8
, Hans Orlent
9
, Peter Michielsen
10
,
Jean Delwaide
11
, Hendrik Reynaert
12
, Michael Adler
2
, Jean Henrion
1
, Pierre Deltenre
1
1
Hôpital de Jolimont, Haine-Saint-Paul, Belgium,
2Hôpital Erasme, Brussels, Belgium,
3KUL Leuven, Belgium,
4CHU Saint-Pierre, Brussels, Belgium,
5UZ, Gent, Belgium,
6Hôpitaux Iris Sud Bracops, Brussels, Belgium,
7CHU Brugmann, Brussels, Belgium,
8Ziekenhuis Oost-Limburg, Genk, Belgium,
9
AZ St Jan, Brugge, Belgium,
10UZ Antwerpen, Edegem, Belgium,
11CHU, Liège, Belgium,
12UZ, Brussels, Belgium
The authors have no financial disclosure related to this study
Introduction: Hepatitis B (HBV) and C (HCV) infections share many epidemiological and clinical similarities but exhibit also important
differences. Moreover, their epidemiological characteristics are evolving in western countries. Nationwide studies comparing representative samples of patients newly diagnosed with HBV or HCV infections have not been reported. Aim: To compare the main epidemiological, biological and histological characteristics of patients with newly diagnosed HBV or HCV infection in Belgium, and to compare their management. Methods: Data of patients with newly diagnosed HBV or HVC infection were extracted from two Belgian registries (HBsAg carriers registry, 2008-2009 and observational survey of hepatitis C, 2003-2004). Results: 705 patients (387 with HBV and 318 with HCV) were included. Compared to HCV patients, HBV patients were younger (36 vs. 44 years, p<0.0001), more frequently male (69 vs. 56%, p<0.0003), less frequently of Caucasian origin (43 vs. 86%, p<0.0001), more frequently black Africans (32 vs. 9%, p<0.0001), less frequently contaminated by transfusion or IV drug use (9 and 6% vs. 33 and 43%, respectively, p<0.0001), more frequently contaminated by sexual or familial transmission (40 and 30% vs. 1 and 1% respectively, p<0.0001). HBV patients had higher rates of normal ALT (65 vs. 36%, p<0.0001), lower rates of ALT >2ULN (15 vs. 38%, p<0.0001), and lower rates of detectable viral nucleic acid by PCR (70 vs. 84%, p<0.0001) than HCV patients. A liver biopsy was performed in 303 patients (in 29% of HBV patients and in 61% of HCV patients, p<0.0001). Twenty-five percents of the patients had extensive fibrosis or cirrhosis (F3/4) (32% of HBV patients, 21% of HCV patients, p=0.04). In multivariate analysis, significant predictors of F3/4 were: older age (p=0.003), male sex (p=0.02), HBV infection (p=0.03), ALT >2ULN (p=0.01) and activity score >2 (p=0.004). HBV patients were less frequently considered for treatment (25 vs. 47%, p<0.0001) than HCV patients. Conclusions: Newly diagnosed HBV and HCV patients disclosed different epidemiological characteristics that should be taken into account for screening. Management of HBV and HCV patients differed, HBV patients undergoing less frequently a liver biopsy and being less frequently considered for treatment..