Time-trends in disease characteristics and comorbidities in patients with chronic hepatitis B in the period 1980–2020

D. P.C. van der Spek*, W. K. Katwaroe, L. A. van Kleef, S. Brakenhoff, R. A. de Man, R. J. de Knegt, A. J. van der Meer, M. J. Sonneveld

*Corresponding author for this work

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Background & aims: The incidence of chronic hepatitis B (CHB) is declining due to successful implementation of vaccination programs and widespread use of antiviral therapy. We aimed to study time-trends in disease characteristics and comorbidities in newly referred CHB patients. Methods: : We collected information on hepatitis B virus (HBV) related disease characteristics (including hepatitis B e-antigen (HBeAg) status, viremia, stage of liver fibrosis and indication for treatment and/or hepatocellular carcinoma (HCC) surveillance) and presence of comorbidities in all CHB patients referred to our center from 1980 through 2020. Patient characteristics were compared according to referral date (before 2000, between 2000 and 2010 and after 2010). Results: : We identified 1515 eligible patients. Patients referred after 2010 were older (36 versus 34 years, p < 0.001), more often non-Caucasian (82.3% versus 55.0%, p < 0.001) and more frequently HBeAg negative (81.5% versus 49.8%, p < 0.001) when compared to patients referred before 2000. Adjusted for ethnicity, sex and age, patients referred after 2010 were less likely to have significant fibrosis (adjusted odds ratio [aOR]:0.178, p < 0.001) or indication for antiviral therapy (aOR:0.342, p < 0.001) but were more likely to be affected by the metabolic syndrome (aOR:1.985, p = 0.013), hepatic steatosis (aOR:1.727, p < 0.001) and metabolic dysfunction associated fatty liver disease (MAFLD) (aOR:1.438, p = 0.013). Conclusions: : The characteristics of the CHB populations are changing. Newly referred patients are older, have less active HBV related liver disease but are more likely to be co-affected by MAFLD. These findings provide guidance for adequate allocation of resources to cope with the changing characteristics of the CHB population.

Original languageEnglish
Pages (from-to)86-92
Number of pages7
JournalEuropean Journal of Internal Medicine
Early online date14 Nov 2022
Publication statusPublished - Jan 2023

Bibliographical note

Funding Information:
The study was sponsored by the Foundation for Liver and Gastrointestinal Research (SLO), Rotterdam, the Netherlands. The project was financially supported by Gilead under grant number IN-NL-988-5952. Neither the SLO nor Gilead had influence on study design, data acquisition or analysis, nor the decision to submit for publication.

Publisher Copyright:
© 2022 The Author(s)


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