Transition rates to cirrhosis and liver cancer by age, gender, disease and treatment status in Asian chronic hepatitis B patients.

Abstract

BACKGROUND:

Increasing hepatitis-related mortality has reignited interest to fulfill the World Health Organization's goal of viral hepatitis elimination by 2030. However, economic barriers have enabled only 28% of countries to implement countermeasures. Given the high disease burden among Asians, we aimed to present age, sex, disease activity and treatment-specific annual progression rates among Asian chronic hepatitis B (CHB) patients to inform health economic modeling efforts and cost-effective public health interventions.

METHODS:

We analyzed 18,056 CHB patients from 36 centers across the U.S. and seven countries/regions of Asia Pacific (9530 treated; 8526 untreated). We used Kaplan-Meier methods to estimate annual incidence of cirrhosis and hepatocellular carcinoma (HCC). Active disease was defined by meeting the APASL treatment guideline criteria.

RESULTS:

Over a median follow-up of 8.55 years, there were 1178 incidences of cirrhosis and 1212 incidences of HCC (297 without cirrhosis, 915 with cirrhosis). Among the 8526 untreated patients (7977 inactive, 549 active), the annual cirrhosis and HCC incidence ranged from 0.26% to 1.30% and 0.04% to 3.80% in inactive patients, and 0.55 to 4.05% and 0.19 to 6.03% in active patients, respectively. Of the 9530 treated patients, the annual HCC rates ranged 0.03-1.57% among noncirrhotic males and 2.57-6.93% among cirrhotic males, with lower rates for females. Generally, transition rates increased with age, male sex, the presence of fibrosis/cirrhosis, and active disease and/or antiviral treatment.

CONCLUSION:

Using data from a large and diverse real-world cohort of Asian CHB patients, the study provided detailed annual transition rates to inform practice, research and public health planning.

• Authors: Matt Liu, Tai-Chung Tseng, Dae Won Jun, Ming-Lun Yeh, Huy Trinh, Grace L H Wong, Chien-Hung Chen, Cheng-Yuan Peng, Sung Eun Kim, Hyunwoo Oh, Min-Sun Kwak, Michael Cheung, Hidenori Toyoda, Yao-Chun Hsu, Jae Yoon Jeong, Eileen L Yoon, Teerapat Ungtrakul, Jian Zhang, Qing Xie, Sang Bong Ahn, Masaru Enomoto, Jae-Jun Shim, Chris Cunningham, Soung Won Jeong, Yong Kyun Cho, Eiichi Ogawa, Rui Huang, Dong-Hyun Lee, Hirokazu Takahashi, Pei-Chien Tsai, Chung-Feng Huang, Chia-Yen Dai, Cheng-Hao Tseng, Satoshi Yasuda, Ritsuzo Kozuka, Jiayi Li, Christopher Wong, Clifford C Wong, Changqing Zhao, Joseph Hoang, Yuichiro Eguchi, Chao Wu, Yasuhito Tanaka, Ed Gane, Tawesak Tanwandee, Ramsey Cheung, Man-Fung Yuen, Hyo-Suk Lee, Ming-Lung Yu, Jia-Horng Kao, Hwai-I Yang, Mindie H Nguyen
• Journal: Hepatology international (Hepatol Int) Vol. 15 Issue 1 Pg. 71-81 (Feb 2021) ISSN: 1936-0541 [Electronic] United States
• PMID: 33394321 (Publication Type: Journal Article)

Chemical References

• Antiviral Agents

Topics

• Antiviral Agents (therapeutic use)
• Asian People
• Carcinoma, Hepatocellular (drug therapy, epidemiology, etiology)
• Female
• Hepatitis B, Chronic (complications, drug therapy, epidemiology)
• Humans
• Liver Cirrhosis (drug therapy, epidemiology, etiology)
• Liver Neoplasms (drug therapy, epidemiology, etiology)
• Male