Clinical and virological features of chronic hepatitis B in the French national surveillance program, 2008–2012: A cross-sectional study
Rattachement africain : fr. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background & Aims: Among people living with HBV, only a subset of individuals with chronic hepatitis is in need of treatment, and this proportion varies according to the population, region, and setting. No estimates of the proportion of people who are infected with HBV and meet the treatment eligibility criteria in France are available. Methods: 552 treatment-naïve individuals with chronic HBV infection referred for the first time to a hepatology reference centre between 2008 and 2012 were prospectively included. Demographic, clinical, and laboratory data were analysed. Results: In total, 61.1% of patients were males, with a median age of 37.5 years. Moreover, 64% were born in an intermediate- or high-HBV endemicity country, and 90% were HBeAg-negative. At referral, median HBV DNA and HBsAg levels were 3.3 and 3.6 log IU/ml, respectively; 37.8% of patients had alanine aminotransferase >40 U/L, and 29.0% had moderate or severe fibrosis (≥F2), including 9.4% with cirrhosis. The most prevalent genotypes were D (34.7%), E (27.4%), and A (25.7%). Coinfections were rare: 2.4% were HIV-positive, 4.0% were HCV-positive, and 6.0% were HDV-positive. According to the 2017 EASL Clinical Practice Guidelines, using a single time point analysis, 2.7% of patients were classified as HBeAg-positive chronic infection, 6.1% as HBeAg-positive chronic hepatitis B, 26.5% as HBeAg-negative chronic hepatitis B, and 61.1% as HBeAg-negative chronic infection, whereas 3.6% patients could not be classified. The performance of HBsAg level quantification to identify individuals with HBeAg-negative chronic hepatitis B was poor. A total of 29.1% met the criteria for initiation of antiviral treatment, whereas 66.5% remained under routine clinical surveillance. Most eligible patients initiated recommended first-line therapies, including tenofovir (45.3%), entecavir (36.8%), or pegylated interferon alpha (11.6%). Conclusions: Of all cases, 9.4% had cirrhosis at presentation and 29.1% met the 2017 EASL Clinical Practice Guidelines treatment criteria. HBsAg levels failed to accurately identify individuals with HBeAg-negative chronic infection. Lay summary: Among French adults chronically infected with HBV referred for the first time to hepatology reference centres, about one-third had a significant liver disease. Approximately one-third of individuals met criteria for initiation of antiviral treatment based on entecavir or tenofovir or, occasionally, pegylated interferon alpha.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Clinical and virological features of chronic hepatitis B in the French national surveillance program, 2008–2012: A cross-sectional study
- Date Crossref
- 01/12/2022
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Inserm pays non établi dans la noticeOrganisme public
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Université Paris-Est Créteil Department of Virology and INSERM U955 pays non établi dans la noticeUniversité ou école supérieure
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Department of Virology pays non établi dans la noticeStructure de recherche
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Institut de Veille Sanitaire pays non établi dans la noticeÉtablissement de santé
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Hôpital Avicenne pays non établi dans la noticeÉtablissement de santé
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Hospices Civils de Lyon pays non établi dans la noticeÉtablissement de santé
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Centre de Recherche en Cancérologie de Lyon pays non établi dans la noticeStructure de recherche
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Hôpital Robert-Debré pays non établi dans la noticeÉtablissement de santé
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National Institute for Public Health Surveillance pays non établi dans la noticeStructure de recherche
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Laboratoire de Microbiologie Clinique pays non établi dans la noticeStructure de recherche
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Cancer Research Center of Lyon (CRCL) Service d'Hépatogastroentérologie pays non établi dans la noticeStructure de recherche
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Laboratoire de Virologie pays non établi dans la noticeStructure de recherche
Inserm, Department of Virology and INSERM U955 — Université Paris-Est Créteil et Department of Virology, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.