Antiviral Therapy Reduces Risk of Cirrhosis in Noncirrhotic HBV Patients Among 4 Urban Safety-Net Health Systems.
Adult
Black or African American
Aged
Alanine
/ therapeutic use
Antiviral Agents
/ therapeutic use
Asian
Carcinoma, Hepatocellular
/ epidemiology
Female
Guanine
/ analogs & derivatives
Hepatitis B, Chronic
/ drug therapy
Humans
Kaplan-Meier Estimate
Liver Cirrhosis
/ epidemiology
Liver Neoplasms
/ epidemiology
Male
Middle Aged
Mortality
Propensity Score
Proportional Hazards Models
Retrospective Studies
Safety-net Providers
Tenofovir
/ analogs & derivatives
United States
/ epidemiology
Urban Population
White People
Journal
The American journal of gastroenterology
ISSN: 1572-0241
Titre abrégé: Am J Gastroenterol
Pays: United States
ID NLM: 0421030
Informations de publication
Date de publication:
01 07 2021
01 07 2021
Historique:
received:
11
08
2020
accepted:
22
01
2021
pubmed:
5
3
2021
medline:
31
8
2021
entrez:
4
3
2021
Statut:
ppublish
Résumé
To evaluate the impact of chronic hepatitis B virus infection (CHB) treatment on risk of cirrhosis, liver-related outcomes, and death among a diverse CHB cohort with a large proportion of African Americans. Adults with noncirrhotic CHB without human immunodeficiency virus from 2010 to 2018 were retrospectively evaluated across 4 US safety-net health systems. CHB was identified with International Classification of Diseases, Ninth Revision/Tenth Revision diagnosis coding and confirmatory laboratory data. Propensity-score matching, Kaplan-Meier methods, and adjusted Cox proportional hazards models were used to evaluate impact of CHB treatment on risk of cirrhosis, hepatocellular carcinoma (HCC), death, and composite of cirrhosis, HCC, or death. Among 4,064 CHB patients (51.9% female, 42.0% age <45 years, 31.6% African American, 26.6% Asian, 26.7% Hispanic), 23.2% received CHB antiviral therapy and 76.8% did not. Among the propensity score-matched cohort (428 treated and 428 untreated), CHB treatment was associated with lower risk of cirrhosis (hazards ratio 0.65, 95% confidence interval 0.46-0.92, P = 0.015) and composite of cirrhosis, HCC, or death (hazards ratio 0.67, 95% confidence interval 0.49-0.94, P = 0.023). Females vs males and African Americans vs non-Hispanic whites had significantly lower risk of cirrhosis. When treatment effects were stratified by age, sex, and ethnicity, the benefits of antiviral therapies in reducing risk of cirrhosis were seen primarily in CHB patients who were females, age <45 years, and of Asian ethnicity. Our propensity score-matched cohort of noncirrhotic CHB patients demonstrated significant reductions in risk of cirrhosis due to CHB treatment.
Identifiants
pubmed: 33661148
doi: 10.14309/ajg.0000000000001195
pii: 00000434-202107000-00020
doi:
Substances chimiques
Antiviral Agents
0
entecavir
5968Y6H45M
Guanine
5Z93L87A1R
Tenofovir
99YXE507IL
tenofovir alafenamide
EL9943AG5J
Alanine
OF5P57N2ZX
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1465-1475Informations de copyright
Copyright © 2021 by The American College of Gastroenterology.
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