Advancing Age and Comorbidity in a US Insured Population‐Based Cohort of Patients With Chronic Hepatitis B

Nguyen, Mindie H.; Lim, Joseph K.; Ozbay, A. Burak; Fraysse, Jeremy; Liou, Iris; Meyer, Nicole; Dusheiko, Geoffrey; Gordon, Stuart C.

doi:10.1002/hep.30246

Cited by 70 publications

(88 citation statements)

References 34 publications

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“…However, the addition of ETV for the treatment of CHB did not cause an interaction with HTN and DM and cause a further decline in renal function. This is an important finding as patients with CHB have been reported been noted to have an increase risk for the development of HTN and DM, but our results suggest that treatment with ETV should not be withheld over concern of hastening renal impairment in the presence of HTN and DM among patients with CHB . In addition, the proportion of patients in each subgroup that had a negative change in their renal function were not found to be significantly different among each other, findings which strengthen our suggestion that ETV should not be withheld as treatment for concern of renal function; however, renal function should be routinely monitored, and treatment individualized for each patient.…”

Section: Discussionsupporting

confidence: 80%

Hepatitis B and renal function: A matched study comparing non‐hepatitis B, untreated, treated and cirrhotic hepatitis patients

Trinh

et al. 2018

Liver International

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Background & Aim Renal impairment is associated with chronic hepatitis B (CHB). To overcome prior study design differences, we used propensity score matching to balance the non‐CHB and CHB cohorts and generalized linear modelling (GLM, models using probit and logit linking functions for complex models) to evaluate the effect of CHB, treatment and cirrhosis on renal function. Methods A retrospective cohort (1996‐2017) from one U.S. university medical centre. Included patients had ≥12 months of serial creatinine laboratories and a baseline estimated glomerular filtration rate (eGFR, by the Modification of Diet in Renal Disease Study equation) ≥60 mL/min/1.73 m2. Propensity score matching was performed using age, sex, ethnicity, diabetes, hypertension and baseline eGFR. GLM was performed to generate adjusted mean eGFR over time. Results Adjusted mean eGFR was significantly higher for non‐CHB vs. untreated CHB patients (eGFR 87.4 vs. 85.6, P= 0.004, n = 580, median follow‐up = 82 months). A significant difference in adjusted mean eGFR between untreated vs. entecavir (ETV)‐treated CHB patients (eGFR 85.1 vs. 83.5, P= 0.02, n = 340, median follow‐up = 70 months) was found among non‐cirrhotic CHB. Among treated CHB, there was no difference in adjusted mean eGFR between non‐cirrhotic vs. cirrhotic patients (eGFR 77.0 vs. 76.5; P= 0.66, n = 112, median follow‐up = 58 months). Conclusion After PSM and GLM, the significant predictors for worsening renal function were age, hypertension and diabetes mellitus but not CHB, ETV or cirrhosis. However, given small sample size, data regarding the use of ETV in patients with cirrhosis should be interpreted with caution and requires additional investigation.

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Section: Discussionsupporting

confidence: 80%

Hepatitis B and renal function: A matched study comparing non‐hepatitis B, untreated, treated and cirrhotic hepatitis patients

Trinh

et al. 2018

Liver International

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“…Within the US population, patients with CHB were found to have a higher Deyo‐Charlson Comorbidity Index compared with a nonmatched CHB group. Patients with CHB had a higher prevalence of alcoholism, cardiovascular disease, diabetes, hepatitis C virus, human immunodeficiency virus, and renal impairment . Interestingly, in a Taiwan‐based study, CHB was found to be associated with decreased risk for ischemic stroke, although this claims‐based study was unable to account for variables such as toxic habits and laboratory data …”

Section: Nonliver Comorbidities Of Chbmentioning

confidence: 93%

“…CHB has also been associated with a higher prevalence of malignancy, including colorectal, pancreatic, gallbladder and biliary duct, kidney, and ovarian cancer, as well as Hodgkin's lymphoma, non‐Hodgkin's lymphoma, and multiple myeloma . There has been some debate regarding the association of CHB and lymphoma .…”

Section: Nonliver Comorbidities Of Chbmentioning

confidence: 99%

“…Patients with CHB had a higher prevalence of alcoholism, cardiovascular disease, diabetes, hepatitis C virus, human immunodeficiency virus, and renal impairment. 13 Interestingly, in a Taiwan-based study, CHB was found to be associated with decreased risk for ischemic stroke, although this claimsbased study was unable to account for variables such as toxic habits and laboratory data. 14 CHB has also been associated with a higher prevalence of malignancy, including colorectal, pancreatic, gallbladder and biliary duct, kidney, and ovarian cancer, as well as Hodgkin's lymphoma, non-Hodgkin's lymphoma, and review multiple myeloma.…”

mentioning

confidence: 98%

“…nOnliver COMOrBiDiTies OF CHB Several population studies on patients with CHB have found associations to nonliver comorbidities such as osteoporosis, chronic kidney disease (CKD), end-stage renal disease, carotid atherosclerosis, alcoholism, cardiovascular disease, diabetes, hepatitis C virus, and human immunodeficiency virus. [10][11][12][13] In a study based in Japan, Ishizaka et al 12 found via ultrasound visualization of carotid plaques that CHB was associated with carotid atherosclerosis. Within the US population, patients with CHB were found to have a higher Deyo-Charlson Comorbidity Index compared with a nonmatched CHB group.…”

mentioning

confidence: 99%

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