Original articlePancreas, biliary tract, and liverTreatment Eligibility of Patients With Chronic Hepatitis B Initially Ineligible for Therapy
Section snippets
Study Design
We conducted a retrospective cohort study of all consecutive patients who presented for CHB evaluation at 2 community-based gastroenterology clinics in Northern California between March 2007 and June 2010.
Electronic medical records of study subjects, inclusive of laboratory, radiology, and pathology results, were collected using a case report form. Laboratory tests were performed at local laboratories operated either by Quest Diagnostics (San Juan Capistrano, CA) or LabCorp (Burlington, NC).
Baseline Clinical Characteristics of Patients at the Initial Evaluation
Of the total 549 treatment-naive patients seen at the initial presentation, more than half (55%) were eligible for anti-HBV treatment, whereas 245 patients (45%) did not meet the criteria for treatment (Figure 2).
Demographic and clinical characteristics of all patients who initially were ineligible for treatment are summarized in Table 1 and by treatment eligibility status during the follow-up evaluation. All patients were either Vietnamese or Vietnamese-Chinese. When compared with patients who
Discussion
In the current study, approximately one-fifth of patients with CHB who initially did not meet treatment criteria for antiviral therapy became eligible for treatment during their follow-up evaluation. There were significantly more patients who became eligible by the US panel algorithm only compared with the AASLD guideline (19% vs 3%; P < .0001). This difference in proportions can be attributed to the lower requirements for HBV DNA (<2000 IU/mL for HBeAg-negative patients) and ALT cut-off values
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Conflicts of interest The authors disclose no conflicts.