Infrequent Clinical Assessment of Chronic Hepatitis B Patients in United States General Healthcare Settings: Table 1.

Spradling, Philip R.; Xing, Jian; Rupp, Loralee B; Moorman, Anne C.; Gordon, Stuart C.; Teshale, Eyasu; Lü, Mei; Boscarino, Joseph A.; Trinacty, Connie Mah; Schmidt, Mark; Holmberg, Scott D.

doi:10.1093/cid/ciw516

Cited by 34 publications

(36 citation statements)

References 12 publications

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“…Liver ultrasound for hepatocellular carcinoma screening was also infrequently performed, though few patients would likely have met current recommendations for screening. Similar findings have been observed in other observational studies . This may have been due to clinicians’ lack of awareness of guidelines for HBV care in pregnant HBV‐infected women.…”

Section: Discussionsupporting

confidence: 88%

Incidence, determinants and outcomes of pregnancy‐associated hepatitis B flares: A regional hospital‐based cohort study

Kushner

Shaw

Kalra

et al. 2017

Liver International

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Section: Discussionsupporting

confidence: 88%

Incidence, determinants and outcomes of pregnancy‐associated hepatitis B flares: A regional hospital‐based cohort study

Kushner

Shaw

Kalra

et al. 2017

Liver International

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“…Our data illustrate the timing of the decline in FIB4 that follows, suggesting a delayed but significant regression of liver fibrosis. In untreated patients, it has long been recognized that the fluctuating nature of chronic HBV infection necessitates careful surveillance; however, a recent study found that such surveillance is often inadequate . This may be cause for concern, as we observe that FIB4 increases in our untreated patient sample, suggesting fibrosis progression—even among the subset of patients who were not candidates for therapy based on current guidelines.…”

Section: Discussionmentioning

confidence: 72%

“…In untreated patients, it has long been recognized that the fluctuating nature of chronic HBV infection necessitates careful surveillance 27 ; however, a recent study found that such surveillance is often inadequate. 28,29 This may be cause for concern, as we observe that FIB4 increases in our untreated patient sample, suggesting fibrosis progressioneven among the subset of patients who were not candidates for therapy based on current guidelines. Because of the observational nature of our study, prospective studies are needed to further characterize which patients are at highest risk for fibrosis progression.…”

Section: Discussionmentioning

confidence: 90%

Long‐term progression of viral load and serum markers of fibrosis among treated and untreated patients with chronic hepatitis B

Gordon

Rupp

et al. 2017

J of Gastro and Hepatol

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Background and Aims Antiviral therapy for patients with hepatitis B (HBV) infection is generally deferred for “immune inactive” patients, although longitudinal changes in viral load and liver fibrosis remain understudied in this population. Likewise, in treated patients, the temporal relationship between changes in viral load and liver fibrosis is not well characterized. Using data from the chronic hepatitis cohort study, the study investigated viral load and the Fibrosis-4 index (FIB4, a serum-based marker of liver fibrosis) trajectories in both untreated and treated HBV patients. Materials and Methods We applied a bivariate, piecewise, linear spline, mixed-effects modeling approach to data from 766 HBV patients (342 untreated, 424 treated). Treatment selection bias was adjusted using propensity scores. Multiple sensitivity analyses were used to confirm results in untreated patients. Results Among all untreated patients, FIB4 began to increase by 0.9% per month (11% per year; P < 0.05) at 28 months post-index date, suggesting fibrosis progression. Significant FIB4 progression was also observed in a subgroup analysis of “immune inactive” untreated patients. In treated patients, viral load declined 31.8% per month (P < 0.05) for the first 5 months after treatment initiation, and 1.4–1.7% per month (P < 0.05) thereafter. At 5 months after treatment initiation, FIB4 began to decline 0.5% per month (P < 0.05), stabilizing at 28 months. Conclusion Among untreated HBV patients, FIB4 gradually increases over time, suggesting fibrosis progression, even in those patients designated as immune inactive. In treated patients, antiviral therapy results in a rapid decline in viral load followed by a delayed decline in markers of liver fibrosis.

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“…Although effective therapies are available for managing HIV, HBV, and HCV infections, these infections sometimes remain undiagnosed because of their often asymptomatic nature [4–6]. Public health efforts to test and link persons with HIV and viral hepatitis infections to care are of crucial importance for mitigating associated morbidity and mortality [7–9].…”

Section: Introductionmentioning

confidence: 99%

HIV and viral hepatitis coinfection analysis using surveillance data from 15 US states and two cities

et al. 2018

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SUMMARY Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. We examined characteristics of HIV and viral hepatitis coinfections by using surveillance data from 15 US states and 2 cities. Each jurisdiction used an automated deterministic matching method to link surveillance data for persons with reported acute and chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, to persons reported with HIV infection. Of the 504398 persons living with diagnosed HIV infection at the end of 2014, 2.0% were coinfected with HBV, and 6.7% were coinfected with HCV. Of the 269884 persons ever reported with HBV, 5.2% were reported with HIV. Of the 1093050 persons ever reported with HCV, 4.3% were reported with HIV. A greater proportion of persons coinfected with HIV and HBV were males and blacks/African Americans, compared with those with HIV monoinfection. Persons who inject drugs represented a greater proportion of those coinfected with HIV and HCV, compared with those with HIV monoinfection. Matching HIV and viral hepatitis surveillance data highlights epidemiological characteristics of persons coinfected and can be used to routinely monitor health status and guide state and national public health interventions.

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Infrequent Clinical Assessment of Chronic Hepatitis B Patients in United States General Healthcare Settings: Table 1.

Cited by 34 publications

References 12 publications

Incidence, determinants and outcomes of pregnancy‐associated hepatitis B flares: A regional hospital‐based cohort study

Incidence, determinants and outcomes of pregnancy‐associated hepatitis B flares: A regional hospital‐based cohort study

Long‐term progression of viral load and serum markers of fibrosis among treated and untreated patients with chronic hepatitis B

HIV and viral hepatitis coinfection analysis using surveillance data from 15 US states and two cities

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