Transcript HBV-HCV BW2011 Poster

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
1
Vroey ,
2
Moreno ,
3
Laleman ,
4
Gossum ,
5
Colle ,
Bénédicte De
Christophe
Wim
Marc van
Isabelle
6
7
8
9
10
Chantal de Galocsy , Philippe Langlet , Geert Robaeys , Hans Orlent , Peter Michielsen ,
11
12
2
1
1
Jean Delwaide , Hendrik Reynaert , Michael Adler , Jean Henrion , Pierre Deltenre
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
Summary
Introduction
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..
Patients
Mean age (years)
Sex ratio (men/women)
Origin
Caucasian
Black African
Other
Risk factors for infection
Transfusion
IV drug use
Sexual behavior
Familial transmission
HBV patients
n=387
36
69% / 31%
HCV patients
n=318
44
56% / 44%
<0.0001
<0.0003
43%
32%
25%
86%
9%
5%
<0.0001
<0.0001
<0.0001
9%
6%
40%
30%
33%
43%
1%
1%
Biological parameters
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.
p value
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).
<0.0001
<0.0001
<0.0001
<0.0001
Histological parameters and management
HBV
HCV
HBV
HCV
Predictors of F3/4 in
multivariate analysis
Biopsy performed
Treatment considered
35%
30%
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
25%
Norm al ALT
ALT>2ULN
Detectable
viral nucleic
acid by PCR
20%
15%
10%
5%
0%
F3/4
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.