Observational Study
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World J Gastroenterol. Oct 7, 2014; 20(37): 13582-13590
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13582
Clinical characteristics and current management of hepatitis B and C in China
Yong-Tao Sun, Yue-Xin Zhang, Hong Tang, Qing Mao, Xiao-Zhong Wang, Ling-Yi Zhang, Hong Chen, Ying-Na Zhong, Shu-Mei Lin, Da-Zhi Zhang
Yong-Tao Sun, Department of Infectious Diseases, Tangdu Hospital, Affiliated to the Fourth Military Medical University, Xi’an 710038, Shaanxi Province, China
Yue-Xin Zhang, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Hong Tang, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Qing Mao, the First Affiliated Hospital of the Third Military Medical University, Chongqing 400039, China
Xiao-Zhong Wang, Traditional Chinese Medicine Hospital of Xinjiang Uygur Administrative Region, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Ling-Yi Zhang, the Second Affiliated Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Hong Chen, the First Affiliated Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Ying-Na Zhong, People’s Hospital of Xinjiang Uygur Administrative Region, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Shu-Mei Lin, the First Affiliated Hospital of Xi'an Jiaotong University, Xi’an 710038, Shaanxi Province, China
Da-Zhi Zhang, the Second Affiliated Hospital of Chongqing Medica University, Chongqing 400039, China
Author contributions: All authors contributed to the acquisition of data, interpretation and analysis of the data, and critical review of the manuscript for important intellectual content; assistance in writing the manuscript was provided by Merck Sharp and Dohme (China) Ltd; all authors read and approved the final manuscript.
Supported by Financial support for this study was provided by Merck Sharp and Dohme (China) Ltd
Correspondence to: Yong-Tao Sun, Department of Infectious Diseases, Tangdu Hospital, Affiliated to the Fourth Military Medical University, No. 569 Xinsi Road, Xi’an 710038, Shaanxi Province, China. yongtaos@hotmail.com
Telephone: +86-29-84777452 Fax: +86-29-83537377
Received: March 24, 2014
Revised: May 16, 2014
Accepted: June 12, 2014
Published online: October 7, 2014
Abstract

AIM: To describe a population of outpatients in China infected by hepatitis B virus (HBV) and/or hepatitis C virus (HCV), and assess their current management status.

METHODS: A multicenter, cross-sectional study of HBV- and/or HCV-infected patients was conducted from August to November, 2011 in western China. Patients ≥ 18 years of age with HBV and/or HCV infections who visited outpatient departments at 10 hospitals were evaluated, whether treated or not. Data were collected on the day of visit from medical records and patient interviews.

RESULTS: A total 4010 outpatients were analyzed, including 2562 HBV-infected and 1406 HCV-infected and 42 HBV/HCV co-infected patients. The median duration of documented infection was 7.5 years in HBV-infected and 1.8 years in HCV-infected patients. Cirrhosis was the most frequent hepatic complication (12.2%), appearing in one-third of patients within 3 years prior to or at diagnosis. The HCV genotype was determined in only 10% of HCV-infected patients. Biopsy data were only available for 54 patients (1.3%). Antiviral medications had been received by 58.2% of patients with HBV infection and 66.6% with HCV infection. Nucleos(t)ide analogs were the major antiviral medications prescribed for HBV-infected patients (most commonly adefovir dipivoxil and lamivudine). Ribavirin + pegylated interferon was prescribed for two-thirds of HCV-infected patients. In the previous 12 mo, around one-fifth patients had been hospitalized due to HBV or HCV infection.

CONCLUSION: This observational, real-life study has identified some gaps between clinical practice and guideline recommendations in China. To achieve better health outcomes, several improvements, such as disease monitoring and optimizing antiviral regimens, should be made to improve disease management.

Keywords: Hepatitis B, Hepatitis C, Clinical characteristics, Treatment

Core tip: This observational, real-life study has identified some gaps between current clinical practice and guideline recommendations for the treatment of hepatitis B and C infections in China. To achieve better health outcomes, the findings of the study point to various improvements that need to be made to align clinical practice more closely with treatment guidelines, including: (1) routine screening for infections so that patients are diagnosed earlier; (2) more thorough evaluation of hepatitis B virus (HBV)/hepatitis C virus (HCV)-infected patients; and (3) the use of more effective antiviral agents for both anti-HBV and anti-HCV therapy and adjustment of the treatments according to the response.