Predictors associated with treatment initiation and switch in a real-world chronic hepatitis B population from five European countries

被引：13

作者：

Leblebicioglu, H. ^{[1
]}

Arama, V. ^{[2
]}

Causse, X. ^{[3
]}

Marcellin, P. ^{[4
]}

Ozaras, R. ^{[5
]}

Postawa-Klozinska, B. ^{[6
]}

Simon, K. ^{[7
]}

Suceveanu, A. I. ^{[8
]}

Wiese, M. ^{[9
]}

Zeuzem, S. ^{[10
]}

Klauck, I. ^{[11
]}

Morais, E. ^{[11
]}

Bjork, S. ^{[12
]}

Lescrauwaet, B. ^{[13
]}

Kamar, D. ^{[14
]}

Zarski, J. P. ^{[15
]}

机构：

[1] Ondokuz Mayis Univ, Med Sch Samsun, Samsun, Turkey

[2] Carol Davila Univ Med & Pharm, Prof Dr Matei Bals Natl Inst Infect Dis, Bucharest, Romania

[3] Hop Source Orleans, Orleans, France

[4] Hop Beaujon, Paris, France

[5] Istanbul Univ, Cerrahpasa Med Fac, Istanbul, Turkey

[6] Specjalist Szpital Zeromskiego, Krakow, Poland

[7] Univ Med, Wroclaw, Poland

[8] Spitalul Clin Judetean Urgenta Constanta, Constanta, Romania

[9] Hosp St Georg, Leipzig, Germany

[10] JW Goethe Univ Hosp, Frankfurt, Germany

[11] Bristol Myers Squibb Co, Paris, France

[12] Inst Appl Econ & Hlth Res, Copenhagen, Denmark

[13] Xintera Consulting, Leuven, Belgium

[14] DOCS, Sevres, France

[15] CHU Grenoble, Clin Univ Hepatogastroenterol, F-38043 Grenoble, France

来源：

JOURNAL OF VIRAL HEPATITIS | 2014年 / 21卷 / 09期

关键词：

adefovir; antiviral treatment; chronic hepatitis B; entecavir; lamivudine; tenofovir; NATURAL-HISTORY; VIRUS INFECTION;

D O I：

10.1111/jvh.12202

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

In Europe, healthcare systems differ between countries and different factors may influence Chronic hepatitis B (CHB) treatment choices in different counties. This analysis from a prospective, longitudinal, non-interventional study in five EU countries aimed to explore determinants associated with treatment initiation or switch in patients with CHB. A total of 1267 adult patients with compensated CHB in Germany, France, Poland, Romania and Turkey were prospectively followed for up to 2years (March 2008-December 2010). Determinants of treatment initiation or switch were analysed using multivariate Cox proportional hazards regression. Median time since CHB diagnosis was 2.6 (0-37.7)years. Among 646 treatment-naive patients, the probability of treatment initiation during follow-up was higher: in Germany (P=0.0006), Poland (P<0.0001) and Romania (P=0.0004) compared with Turkey; in patients with alanine transaminase (ALT) 1-2xupper limit of normal (ULN) (P=0.0580) or >2xULN (P=0.0523) compared with ALT 1xULN; and in patients with hepatitis B virus (HBV) DNA 2000IU/mL (P<0.0001) compared with HBV DNA <2000IU/mL or undetectable. Among 567 treated patients, 87 switched treatment during follow-up. The probability of treatment switch was higher: in France (P=0.0029), Germany (P=0.0078) and Poland (P=0.0329) compared with Turkey; and in patients with HBV DNA <2000 (P<0.0001) or 2000IU/mL (P<0.0001), compared with undetectable. Viral load and ALT level were identified as the major drivers of treatment initiation. HBV DNA level was also a significant determinant of treatment switch. Results were statistically different across EU countries.

引用

页码：662 / 670

页数：9

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