High Prevalence of Cirrhosis in Adults With Chronic HBV at a Safety-Net Hospital

Diseased Liver
Diseased Liver
Investigators aimed to determine rates and predictors of cirrhosis and cirrhosis-related complications in patients with chronic hepatitis B infection.

Of adults with chronic hepatitis B virus (HBV) infection seen at a safety-net hospital, nearly 30% had cirrhosis at initial presentation, with older male patients being at the highest risk, according to a retrospective study published in the Journal of Clinical and Experimental Hepatology.1

Cirrhosis is a serious consequence of HBV infection that is associated with a financial burden of $13 billion in the United States.2,3 Delays in HBV and cirrhosis diagnosis are often more common in the underserved population, leading to greater morbidity and mortality.4-7 To evaluate rates and predictors of cirrhosis and cirrhosis-related complications among adults with chronic HBV, researchers evaluated 329 consecutive adults with chronic HBV who were seen from July 2014 to May 2016 at gastroenterology clinics in a large safety-net hospital system that provides medical care to an ethnically diverse indigent population.1 

They found that 27.7% had cirrhosis at presentation, 4.3% had ascites, 3.7% had variceal bleeding, 4.9% had hepatic encephalopathy, and 4.0% had hepatocellular carcinoma. Men were more likely to have cirrhosis and variceal bleeding at presentation than women. In addition, older age and a positive hepatitis B surface antigen test were associated with a greater risk for cirrhosis at presentation.

“In conclusion, among adults with chronic HBV at an ethnically diverse safety-net hospital system, nearly 30% of patients had cirrhosis at initial presentation, with the greatest risk seen in older male patients,” the investigators stated.1 In addition, “more studies are needed to better identify provider-specific and patient-specific factors that contribute to suboptimal HBV screening and management such that targeted interventions can improve HBV linkage to care and treatment.”

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  1. Tang E, Torres S, Liu B, Baden R, Bhuket T, Wong RJ. High prevalence of cirrhosis at initial presentation among safety-net adults with chronic hepatitis B virus infection. J Clin Exp Hepatol. 2018;8:235-240.
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