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Are patients with HBV and HCV infection different? Comparison between 2 cohorts of newly diagnosed cases included in prospective registries of the Belgian Association for the Study of the Liver

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Academic year: 2021

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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,

2

Hôpital Erasme, Brussels, Belgium,

3

KUL Leuven, Belgium,

4

CHU Saint-Pierre, Brussels, Belgium,

5

UZ, Gent, Belgium,

6

Hôpitaux Iris Sud Bracops, Brussels, Belgium,

7

CHU Brugmann, Brussels, Belgium,

8

Ziekenhuis Oost-Limburg, Genk, Belgium,

9

AZ St Jan, Brugge, Belgium,

10

UZ Antwerpen, Edegem, Belgium,

11

CHU, Liège, Belgium,

12

UZ, 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..

Conclusions

1/ In Belgium, newly diagnosed HBV and HCV patients disclose different epidemiological characteristics that should

be taken into account for screening.

2/ Management of HBV and HCV patients also differs, HBV patients undergoing less frequently a liver biopsy and

being less frequently considered for treatment.

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 HCV infection were extracted from two

Belgian registries (HBsAg carriers registry,

2008-2009 and observational survey of

hepatitis C, 2003-2004).

Patients

HBV patients

n=387

HCV patients

n=318

p value

Mean age (years)

36

44

<0.0001

Sex ratio (men/women)

69% / 31%

56% / 44%

<0.0003

Origin

Caucasian

43%

86%

<0.0001

Black African

32%

9%

<0.0001

Other

25%

5%

<0.0001

Risk factors for infection

Transfusion

9%

33%

<0.0001

IV drug use

6%

43%

<0.0001

Sexual behavior

40%

1%

<0.0001

Familial transmission

30%

1%

<0.0001

Histological parameters and management

Biological parameters

Predictors of F3/4 in

multivariate analysis

Older age

p=0.003

Male sex

p=0.02

HBV infection

p=0.03

ALT>2ULN

p=0.01

Activity score >2

p=0.004

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