Matt Liu1,2, Tai-Chung Tseng3, Dae Won Jun4, Ming-Lun Yeh5, Huy Trinh6, Grace L H Wong7, Chien-Hung Chen8, Cheng-Yuan Peng9, Sung Eun Kim10, Hyunwoo Oh11, Min-Sun Kwak11, Michael Cheung12, Hidenori Toyoda13, Yao-Chun Hsu14, Jae Yoon Jeong15, Eileen L Yoon16, Teerapat Ungtrakul17, Jian Zhang18, Qing Xie19, Sang Bong Ahn20, Masaru Enomoto21, Jae-Jun Shim22, Chris Cunningham23, Soung Won Jeong24, Yong Kyun Cho25, Eiichi Ogawa26, Rui Huang27, Dong-Hyun Lee28, Hirokazu Takahashi29, Pei-Chien Tsai5, Chung-Feng Huang5, Chia-Yen Dai5, Cheng-Hao Tseng14, Satoshi Yasuda13, Ritsuzo Kozuka21, Jiayi Li30, Christopher Wong31, Clifford C Wong31, Changqing Zhao32, Joseph Hoang1, Yuichiro Eguchi29, Chao Wu27, Yasuhito Tanaka33, Ed Gane34, Tawesak Tanwandee35, Ramsey Cheung1, Man-Fung Yuen12, Hyo-Suk Lee11, Ming-Lung Yu5, Jia-Horng Kao3, Hwai-I Yang36, Mindie H Nguyen37. 1. Division of Gastroenterology and Hepatology, Stanford University Medical Center, 780 Welch Road, CJ250K, Palo Alto, CA, 94304, USA. 2. University of Washington, Seattle, WA, USA. 3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. 4. Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Republic of Korea. 5. Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Hepatitis Research Center, College of Medicine and Cohort Research Center and Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan. 6. San Jose Gastroenterology, San Jose, CA, USA. 7. Department of Gastroenterology and Hepatology, The Chinese University of Hong Kong, Hong Kong SAR, China. 8. Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. 9. Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan. 10. Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea. 11. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. 12. Department of Medicine, The University of Hong Kong, Hong Kong SAR, China. 13. Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan. 14. Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan. 15. Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea. 16. Department of Internal Medicine, Sanggye Paik Hospital, Inje University, Seoul, Republic of Korea. 17. Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand. 18. Chinese Hospital, San Francisco, CA, USA. 19. Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China. 20. Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Republic of Korea. 21. Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan. 22. Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea. 23. Research Centre for Maori Health and Development, Massey University, Wellington, New Zealand. 24. Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea. 25. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 26. Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan. 27. Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China. 28. Department of Gastroenterology, Good Gang-An Hospital, Busan, Republic of Korea. 29. Liver Center, Saga University Hospital, Saga, Japan. 30. Palo Alto Medical Foundation, Mountain View Division, Mountain View, CA, USA. 31. Wong Clinics, San Francisco, CA, USA. 32. Department of Cirrhosis, Institute of Liver Disease, Shuguang Hospital Affiliated to Shanghai University of T.C.M., Shanghai, People's Republic of China. 33. Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 34. New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New Zealand. 35. Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. 36. Genomics Research Center, Academia Sinica, Taipei, Taiwan. 37. Division of Gastroenterology and Hepatology, Stanford University Medical Center, 780 Welch Road, CJ250K, Palo Alto, CA, 94304, USA. mindiehn@stanford.edu.
Abstract
BACKGROUND: Increasing hepatitis-related mortality has reignited interest to fulfill the World Health Organization's goal of viral hepatitis elimination by 2030. However, economic barriers have enabled only 28% of countries to implement countermeasures. Given the high disease burden among Asians, we aimed to present age, sex, disease activity and treatment-specific annual progression rates among Asian chronic hepatitis B (CHB) patients to inform health economic modeling efforts and cost-effective public health interventions. METHODS: We analyzed 18,056 CHB patients from 36 centers across the U.S. and seven countries/regions of Asia Pacific (9530 treated; 8526 untreated). We used Kaplan-Meier methods to estimate annual incidence of cirrhosis and hepatocellular carcinoma (HCC). Active disease was defined by meeting the APASL treatment guideline criteria. RESULTS: Over a median follow-up of 8.55 years, there were 1178 incidences of cirrhosis and 1212 incidences of HCC (297 without cirrhosis, 915 with cirrhosis). Among the 8526 untreated patients (7977 inactive, 549 active), the annual cirrhosis and HCC incidence ranged from 0.26% to 1.30% and 0.04% to 3.80% in inactive patients, and 0.55 to 4.05% and 0.19 to 6.03% in active patients, respectively. Of the 9530 treated patients, the annual HCC rates ranged 0.03-1.57% among noncirrhotic males and 2.57-6.93% among cirrhotic males, with lower rates for females. Generally, transition rates increased with age, male sex, the presence of fibrosis/cirrhosis, and active disease and/or antiviral treatment. CONCLUSION: Using data from a large and diverse real-world cohort of Asian CHB patients, the study provided detailed annual transition rates to inform practice, research and public health planning.
BACKGROUND: Increasing hepatitis-related mortality has reignited interest to fulfill the World Health Organization's goal of viral hepatitis elimination by 2030. However, economic barriers have enabled only 28% of countries to implement countermeasures. Given the high disease burden among Asians, we aimed to present age, sex, disease activity and treatment-specific annual progression rates among Asian chronic hepatitis B (CHB) patients to inform health economic modeling efforts and cost-effective public health interventions. METHODS: We analyzed 18,056 CHB patients from 36 centers across the U.S. and seven countries/regions of Asia Pacific (9530 treated; 8526 untreated). We used Kaplan-Meier methods to estimate annual incidence of cirrhosis and hepatocellular carcinoma (HCC). Active disease was defined by meeting the APASL treatment guideline criteria. RESULTS: Over a median follow-up of 8.55 years, there were 1178 incidences of cirrhosis and 1212 incidences of HCC (297 without cirrhosis, 915 with cirrhosis). Among the 8526 untreated patients (7977 inactive, 549 active), the annual cirrhosis and HCC incidence ranged from 0.26% to 1.30% and 0.04% to 3.80% in inactive patients, and 0.55 to 4.05% and 0.19 to 6.03% in active patients, respectively. Of the 9530 treated patients, the annual HCC rates ranged 0.03-1.57% among noncirrhotic males and 2.57-6.93% among cirrhotic males, with lower rates for females. Generally, transition rates increased with age, male sex, the presence of fibrosis/cirrhosis, and active disease and/or antiviral treatment. CONCLUSION: Using data from a large and diverse real-world cohort of Asian CHB patients, the study provided detailed annual transition rates to inform practice, research and public health planning.
Entities:
Keywords:
Antiviral therapy; Asia pacific; Disease progression; Epidemiology; Fibrosis; Hepatitis B virus; Hepatocellular carcinoma; International; Multicenter; Natural history
Authors: Kang Li; Yi Song; Ling Qin; Ang Li; Sanjie Jiang; Lei Ren; Chaoran Zang; Jianping Sun; Yan Zhao; Yonghong Zhang Journal: Front Oncol Date: 2021-10-20 Impact factor: 6.244