Adherence to Anti-Viral Treatment for Chronic Hepatitis B

Abu‐Freha, Naim; Tailakh, Muhammad Abu; Fich, Alexander; Bader, Nasreen Abu; Shemer‐Avni, Yonat; Alsana, F; Gasper, Nava; Abu-Kaf, Heba; Etzion, Ohad

doi:10.3390/jcm9061922

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…Long-term NUC treatment can present challenges, including poor adherence, economic burdens and psychological stressors. 27 A large nationwide Japanese study revealed that a significant number of CHB patients starting antiviral therapy expressed concerns about medication costs. 28 Moreover, some patients reported that the need for treatment made them perceive themselves as sicker.…”

Section: Discussionmentioning

confidence: 99%

“…While treatment can have positive effects, such as increased confidence, especially in patients with undetectable viral loads who are less likely to transmit the virus, it is important to acknowledge that negative aspects exist as well. Long‐term NUC treatment can present challenges, including poor adherence, economic burdens and psychological stressors 27 . A large nationwide Japanese study revealed that a significant number of CHB patients starting antiviral therapy expressed concerns about medication costs 28 .…”

Section: Discussionmentioning

confidence: 99%

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Chronic hepatitis B beyond clinical burden: Psychosocial effects and impact on quality of life

Natour,

Midlej,

Mahajna

et al. 2023

Journal of Viral Hepatitis

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Chronic hepatitis B (CHB) infection has far‐reaching implications for patients' quality of life (QOL), regardless of cirrhosis or complications. However, limited research exists on the psychosocial impact of CHB, particularly in asymptomatic, noncirrhotic patients. Noncirrhotic CHB patients without comorbidities affecting QOL were evaluated in hepatology clinics. Patients underwent a standardized interview and completed the Short Form‐12 (SF‐12) questionnaire. Multiple social and psychological parameters were compared between patients receiving chronic treatment and untreated controls with HBeAg‐negative chronic infections. A total of 41 CHB patients were included in the study, with 41% in the treatment group and 59% in the control group. Both groups showed a male predominance, and their average age, ethnic distribution and family status were comparable. High unemployment rates and discrimination at work due to HBV status were prevalent, with many patients feeling their career choices were influenced by HBV, particularly among untreated patients. Treated patients reported significantly lower scores in general health perception (41% vs. 13%; p = .06) and limitation of usual activity secondary to CHB (29% vs. 0%; p = .008), resulting in a substantial impact on overall health‐related QOL. This study highlights the psychosocial implications of CHB in asymptomatic, noncirrhotic patients, underscoring the importance of comprehensive support and increased awareness. Additionally, addressing challenges related to long‐term treatment, such as adherence and cost, may have the potential to improve patient well‐being and outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Chronic hepatitis B beyond clinical burden: Psychosocial effects and impact on quality of life

Natour,

Midlej,

Mahajna

et al. 2023

Journal of Viral Hepatitis

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“…Among the 529 patients with HBV reactivation, 70.9% of them were triggered by cessation of antiviral treatment. Although both guidelines of APASL, EASL, and AASLD have put forward elaborate recommendations on NUCs treatment and withdrawal, it is still common in clinical practice that patients have poor adherence and stop NUCs treatment under various reasons, with a reported treatment adherence about 46.4%–74.6% ( Ford et al, 2018 ; Abu-Freha et al, 2020 ), which may results in virological breakthrough and increasement of mortality ( Abu-Freha et al, 2020 ). Taken together, it suggests that more attention should be paid on the adherence of antiviral treatment in CHB patients to avoid HBV reactivation and its related critical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…adherence and stop NUCs treatment under various reasons, with a reported treatment adherence about 46.4%-74.6% (Ford et al, 2018;Abu-Freha et al, 2020), which may results in virological breakthrough and increasement of mortality (Abu-Freha et al, 2020). Taken together, it suggests that more attention should be paid on the adherence of antiviral treatment in CHB patients to avoid HBV reactivation and its related critical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B Virus Reactivation Increased the Risk of Developing Hepatic Failure and Mortality in Cirrhosis With Acute Exacerbation

Zhu

Wang

et al. 2022

Front. Microbiol.

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Background and AimsHepatitis B virus (HBV) reactivation is a serious condition and has been extensively described in chemotherapeutic immunosuppressive population. However, little is known about HBV reactivation in immunocompetent patients with chronic hepatitis B (CHB). In this study, we evaluated the prevalence and the clinical significance of HBV reactivation in CHB patients with acute exacerbations.MethodPatients were screened from two prospective multicenter observational cohorts (CATCH-LIFE cohort). A total of 1,020 CHB patients with previous antiviral treatment history were included to assess the prevalence, risk factors, clinical characteristics of HBV reactivation, and its influence on the progression of chronic liver disease.ResultsThe prevalence of HBV reactivation was 51.9% in CHB patients with acute exacerbations who had antiviral treatment history in our study. Among the 529 patients with HBV reactivation, 70.9% of them were triggered by discontinued antiviral treatment and 5.9% by nucleos(t)ide analogs (NUCs) resistance. The prevalence of antiviral treatment disruption and NUCs resistance in patients with HBV reactivation is much higher than that in the patients without (70.9% vs. 0.2%, and 5.9% vs. 0, respectively, both p < 0.001). Stratified and interaction analysis showed that HBV reactivation was correlated with high short-term mortality in cirrhosis subgroup (HR = 2.1, p < 0.001). Cirrhotic patients with HBV reactivation had a significantly higher proportion of developing hepatic failure (45.0% vs. 20.3%, p < 0.001), acute-on-chronic liver failure (ACLF; 31.4% vs. 21.8%, p = 0.005), and short-term death (14.0% vs. 5.9% for 28-day, and 23.3% vs. 12.4% for 90-day, both p < 0.001) than those without. HBV reactivation is an independent risk factor of 90-day mortality for cirrhosis patients (OR = 1.70, p = 0.005), as well as hepatic encephalopathy, ascites, and bacterial infection.ConclusionThis study clearly demonstrated that there was a high prevalence of HBV reactivation in CHB patients, which was mainly triggered by discontinued antiviral treatment. The HBV reactivation strongly increased the risk of developing hepatic failure, ACLF and short-term death in HBV-related cirrhotic patients, which may suggest that HBV reactivation would be a new challenge in achieving the WHO target of 65% reduction in mortality from hepatitis B by 2030.

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“…In addition, it might be relevant to know the rate of adherence to treatment of other asymptomatic viral infections in the same population. For example, in a study we conducted, there was no significant difference between the AB and Jewish people living in the Negev regarding adherence to chronic hepatitis B treatment [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccination Among the Arab Bedouin Population: Lessons Learned From a Minority Population

Abu‐Freha

Alsana²,

El‐Saied³

et al. 2022

Int J Public Health

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Objectives: We investigated the causes of low COVID-19 vaccination rates among a minority population and highlighted interventions for increasing the vaccination rate.Methods: We reviewed the experience during the mass vaccination campaign period among the Arab Bedouin (AB) in Israel, attempting to determine important causes of low vaccination rates and gathered information from real-life experience and through direct contact with the population during the campaign.Results: Causes for low vaccination rates in the AB are related to the health system infrastructure, crisis management strategies, and population characteristics. Long-standing socioeconomic inequalities, limited resources, and language and culture barriers present special challenges to the task of COVID-19 vaccination campaigns. Key interventions for increasing vaccination rates among minority populations include raising awareness, improving vaccination access, and directly targeting risk-groups. To maximize the effectiveness of these interventions they should be culturally adapted and executed according to the needs of each individual target community.Conclusion: Culturally adapted awareness campaigns, interventions, and improved access to vaccines can be accomplished by cooperation between relevant governing and community bodies to increase COVID-19 vaccination rates among minorities.

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Adherence to Anti-Viral Treatment for Chronic Hepatitis B

Cited by 7 publications

References 20 publications

Chronic hepatitis B beyond clinical burden: Psychosocial effects and impact on quality of life

Chronic hepatitis B beyond clinical burden: Psychosocial effects and impact on quality of life

Hepatitis B Virus Reactivation Increased the Risk of Developing Hepatic Failure and Mortality in Cirrhosis With Acute Exacerbation

COVID-19 Vaccination Among the Arab Bedouin Population: Lessons Learned From a Minority Population

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