Background: Chronic HBV infection is still a major health prob- lem in Europe, intensified by increasing immigration from endemic areas. The Master-B study was aimed at defining the current profile of chronic HBV-infected individuals and their long-term clinical outcome. Methods: Consecutive HBsAg-posi- tive patients seen in 77 Italian specialized centers were enrolled from June 2009 to December 2011, using an elec- tronic CRF. HIV-positive patients were excluded. Follow- up data are recorded at least twice a year. We present the baseline characteristics from the final database of 2920 patients. Results: Males were 68.6%; age 49.4±14.3; BMI 25.3±3.8; 26.7% were immigrants, mainly from Eastern Europe, Asia or Africa. Laboratory features included : mean ALT 64±163; 12.3% HBeAg-positive; anti-HDV in 159/1936 (pos/tested; 8.2%) and anti-HCV positive in 81/2170 (3.7%), alcohol use (>3 drinks/day) in <3%; 41.9 % had undergone liver biopsy. Overall, 22% of the patients had cirrhosis, 29% of whom with decompensation, 58.3% chronic hepatitis and 19.5% were inactive carriers. As compared with Italian patients, immigrants were younger (37±11 vs 53.4±13.1 P<0.001), more fre- quently HBeAg-positive (23.4% vs 8.2% P<0.001), anti-HDV- positive (10.9 % vs 7.2 %; P<0.02) and less frequently had undergone liver biopsy. Previous antiviral treatment was recorded in 33% of the cases and at the time of enrolment 35% of the patients were being treated with antivirals (50% of cir- rhotics). Conclusions: Chronic HBV infection shows an evolving burden due to the growing cohort of non-Italian patients, who show higher rates of HBeAg or presence of anti-HDV. There are still barriers to access medical care for cirrhotic patients since 50% of them did not receive antiviral treatment when first seen in the specialized centers.
Changing the Face of Chronic Hepatitis B. Final Report of the Master-B Italian Cohort
Carlo Contini.Membro del Collaboration Group
;
2013
Abstract
Background: Chronic HBV infection is still a major health prob- lem in Europe, intensified by increasing immigration from endemic areas. The Master-B study was aimed at defining the current profile of chronic HBV-infected individuals and their long-term clinical outcome. Methods: Consecutive HBsAg-posi- tive patients seen in 77 Italian specialized centers were enrolled from June 2009 to December 2011, using an elec- tronic CRF. HIV-positive patients were excluded. Follow- up data are recorded at least twice a year. We present the baseline characteristics from the final database of 2920 patients. Results: Males were 68.6%; age 49.4±14.3; BMI 25.3±3.8; 26.7% were immigrants, mainly from Eastern Europe, Asia or Africa. Laboratory features included : mean ALT 64±163; 12.3% HBeAg-positive; anti-HDV in 159/1936 (pos/tested; 8.2%) and anti-HCV positive in 81/2170 (3.7%), alcohol use (>3 drinks/day) in <3%; 41.9 % had undergone liver biopsy. Overall, 22% of the patients had cirrhosis, 29% of whom with decompensation, 58.3% chronic hepatitis and 19.5% were inactive carriers. As compared with Italian patients, immigrants were younger (37±11 vs 53.4±13.1 P<0.001), more fre- quently HBeAg-positive (23.4% vs 8.2% P<0.001), anti-HDV- positive (10.9 % vs 7.2 %; P<0.02) and less frequently had undergone liver biopsy. Previous antiviral treatment was recorded in 33% of the cases and at the time of enrolment 35% of the patients were being treated with antivirals (50% of cir- rhotics). Conclusions: Chronic HBV infection shows an evolving burden due to the growing cohort of non-Italian patients, who show higher rates of HBeAg or presence of anti-HDV. There are still barriers to access medical care for cirrhotic patients since 50% of them did not receive antiviral treatment when first seen in the specialized centers.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
