Carla S Coffin1, Alnoor Ramji2, Curtis L Cooper2, David Miles2, Karen E Doucette2, Philip Wong2, Edward Tam2, David K Wong2, Alexander Wong2, Sylvester Ukabam2, Robert J Bailey2, Keith Tsoi2, Brian Conway2, Lisa Barrett2, Tomasz I Michalak2, Stephen E Congly2, Gerald Minuk2, Kelly Kaita2, Erin Kelly2, Hin Hin Ko2, Harry L A Janssen2, Julia Uhanova2, Brendan C Lethebe2, Sarah Haylock-Jacobs2, Mang M Ma2, Carla Osiowy2, Scott K Fung2. 1. Cumming School of Medicine (Coffin, Lethebe, Congly, Haylock-Jacobs), University of Calgary, Calgary, Alta.; Division of Gastroenterology (Ramji, Ko), Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Cooper), University of Ottawa, Ottawa Hospital Research Institute; Division of Gastroenterology (Kelly), Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Medicine (Doucette, Ma), University of Alberta, Edmonton, Alta.; Division of Gastroenterology (P. Wong), Department of Medicine, McGill University, Royal Victoria Hospital, Montréal, Que.; LAIR Centre (Tam), Vancouver, BC; Department of Medicine (D. Wong, Janssen, Fung), University of Toronto, Toronto Centre for Liver Disease, Toronto, Ont.; Department of Medicine (A. Wong), University of Saskatchewan; Regina General Hospital (Ukabam), Regina, Sask.; Bailey Health Clinic (Bailey), Edmonton, Alta.; Department of Medicine (Tsoi), McMaster University, St. Joseph's Healthcare, Hamilton, Ont.; Vancouver Infectious Diseases Centre (Conway), Vancouver, BC; Division of Infectious Diseases (Barrett), Dalhousie University, Halifax, NS; Faculty of Medicine (Michalak), Memorial University of Newfoundland, St. John's, Nfld.; Department of Internal Medicine (Minuk, Uhanova, Miles, Kaita), University of Manitoba; National Microbiology Laboratory (Osiowy), Public Health Agency of Canada, Winnipeg, Man. cscoffin@ucalgary.ca. 2. Cumming School of Medicine (Coffin, Lethebe, Congly, Haylock-Jacobs), University of Calgary, Calgary, Alta.; Division of Gastroenterology (Ramji, Ko), Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC; Division of Infectious Diseases (Cooper), University of Ottawa, Ottawa Hospital Research Institute; Division of Gastroenterology (Kelly), Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Medicine (Doucette, Ma), University of Alberta, Edmonton, Alta.; Division of Gastroenterology (P. Wong), Department of Medicine, McGill University, Royal Victoria Hospital, Montréal, Que.; LAIR Centre (Tam), Vancouver, BC; Department of Medicine (D. Wong, Janssen, Fung), University of Toronto, Toronto Centre for Liver Disease, Toronto, Ont.; Department of Medicine (A. Wong), University of Saskatchewan; Regina General Hospital (Ukabam), Regina, Sask.; Bailey Health Clinic (Bailey), Edmonton, Alta.; Department of Medicine (Tsoi), McMaster University, St. Joseph's Healthcare, Hamilton, Ont.; Vancouver Infectious Diseases Centre (Conway), Vancouver, BC; Division of Infectious Diseases (Barrett), Dalhousie University, Halifax, NS; Faculty of Medicine (Michalak), Memorial University of Newfoundland, St. John's, Nfld.; Department of Internal Medicine (Minuk, Uhanova, Miles, Kaita), University of Manitoba; National Microbiology Laboratory (Osiowy), Public Health Agency of Canada, Winnipeg, Man.
Abstract
BACKGROUND: Published Canadian epidemiologic data on hepatitis B virus (HBV) infection include single-centre studies or are focused on Indigenous populations. We performed a study to characterize the demographic and clinical features, liver disease status and treatment of people with chronic hepatitis B in Canada. METHODS: In this descriptive, opportunistic, cross-sectional study, available data for people known to be monoinfected with HBV were collected by the Canadian HBV Network from existing clinical databases, with support from the National Microbiology Laboratory, Public Health Agency of Canada. Data were collected in all provinces with the exception of New Brunswick and Newfoundland and Labrador. We analyzed the data using parametric and nonparametric statistical methods, with a significance level of p < 0.05. RESULTS: In the 9380 unique patient records reviewed, the median age was 48 years, and 5193 patients (55.4%) were male. Ethnicity information was available for 7858 patients, of whom 5803 (73.8%) were Asian, 916 (11.6%) were black and 914 (11.6%) were white. Most of those tested (5556/6796 [81.8%]) were negative for HBV e-antigen, and most of those with fibrosis data (3481/4260 [81.7%]) had minimal liver fibrosis, with more advanced fibrosis noted in older people (> 40 yr). Of the 980 patients with genotype data, 521 (53.2%) had genotype B or C infection. Most of the 9241 patients with known confirmed treatment status received tenofovir disoproxil fumarate (1655 [17.9%]), lamivudine (1434 [15.5%]) or entecavir (548 [5.9%]). INTERPRETATION: Based on available data, Canadian patients with chronic hepatitis B are predominantly Asian and negative for HBV e-antigen, and have genotype B or C infection. Interprovincial variations were noted in antiviral treatment regimen. This multicentre nationwide study provides data regarding patients with chronic hepatitis B and may inform future studies on the epidemiologic features of HBV infection in Canada. Copyright 2019, Joule Inc. or its licensors.
BACKGROUND: Published Canadian epidemiologic data on hepatitis B virus (HBV) infection include single-centre studies or are focused on Indigenous populations. We performed a study to characterize the demographic and clinical features, liver disease status and treatment of people with chronic hepatitis B in Canada. METHODS: In this descriptive, opportunistic, cross-sectional study, available data for people known to be monoinfected with HBV were collected by the Canadian HBV Network from existing clinical databases, with support from the National Microbiology Laboratory, Public Health Agency of Canada. Data were collected in all provinces with the exception of New Brunswick and Newfoundland and Labrador. We analyzed the data using parametric and nonparametric statistical methods, with a significance level of p < 0.05. RESULTS: In the 9380 unique patient records reviewed, the median age was 48 years, and 5193 patients (55.4%) were male. Ethnicity information was available for 7858 patients, of whom 5803 (73.8%) were Asian, 916 (11.6%) were black and 914 (11.6%) were white. Most of those tested (5556/6796 [81.8%]) were negative for HBV e-antigen, and most of those with fibrosis data (3481/4260 [81.7%]) had minimal liver fibrosis, with more advanced fibrosis noted in older people (> 40 yr). Of the 980 patients with genotype data, 521 (53.2%) had genotype B or C infection. Most of the 9241 patients with known confirmed treatment status received tenofovir disoproxil fumarate (1655 [17.9%]), lamivudine (1434 [15.5%]) or entecavir (548 [5.9%]). INTERPRETATION: Based on available data, Canadian patients with chronic hepatitis B are predominantly Asian and negative for HBV e-antigen, and have genotype B or C infection. Interprovincial variations were noted in antiviral treatment regimen. This multicentre nationwide study provides data regarding patients with chronic hepatitis B and may inform future studies on the epidemiologic features of HBV infection in Canada. Copyright 2019, Joule Inc. or its licensors.
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