Increasing Treatment Uptake for Chronic Hepatitis B in South America: A Comparative Analysis of Country‐Specific and WHO 2024 Guidelines

Le résumé fourni par la source

The 2024 WHO guidelines for chronic hepatitis B (CHB) aim to expand and simplify treatment eligibility. We aimed to estimate treatment eligibility and uptake according to country-specific guidelines and evaluate treatment expansion based on the WHO guidelines. Treatment-naïve CHB patients from Argentina, Brazil, Chile and Uruguay referred to evaluation between January 2010 and June 2024 were retrospectively included. Treatment candidacy was evaluated according to both country-specific and WHO guidelines. A total of 719 patients with CHB, treatment naïve, were included (67.1% male; median age: 50.4 years; HBeAg-positive: 36.3%). The median HBV-DNA level was 43,000 (IQR 633-110,000,000) IU/mL, median ALT was 41 (IQR 23-99) U/L, 47.0% had an APRI > 0.5 and 21.1% had cirrhosis. According to country-specific guidelines, 56.9% (95% CI: 53.2-60.5) met the criteria for treatment. Antiviral treatment was initiated in 84.3% of eligible patients. The proportion of patients meeting treatment criteria under the WHO guidelines increased to 67.3% (95% CI: 63.8-70.6), resulting in a 10.4% (95% CI: 8.1-12.8) increase in treatment candidacy. Treatment expansion was significantly higher in women (15.2%; 95% CI: 10.2-20.1) than in men (8.1%; 95% CI: 5.4-10.7). According to WHO guidelines, a considerable proportion of CHB patients who do not meet country-specific criteria are eligible for antiviral therapy. Implementing WHO criteria can enhance treatment rates and advance efforts toward CHB elimination.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.