Epidemiologic and clinical features of chronic hepatitis B virus infection in 8 Canadian provinces: a descriptive study by the Canadian HBV Network.

CMAJ open Pub Date : 2019-10-01 DOI:10.9778/cmajo.20190103
C. Coffin, A. Ramji, C. Cooper, D. Miles, K. Doucette, P. Wong, E. Tam, D. Wong, A. Wong, Sylvester Ukabam, R. Bailey, K. Tsoi, B. Conway, Lisa P. Barrett, T. Michalak, S. Congly, G. Minuk, K. Kaita, E. Kelly, H. Ko, H. Janssen, J. Uhanova, B. Lethebe, S. Haylock-Jacobs, M. Ma, C. Osiowy, S. Fung
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引用次数: 15

Abstract

BACKGROUND Published Canadian epidemiologic data on hepatitis B virus (HBV) infection include single-centre studies or are focused on Indigenous populations. We performed a study to characterize the demographic and clinical features, liver disease status and treatment of people with chronic hepatitis B in Canada. METHODS In this descriptive, opportunistic, cross-sectional study, available data for people known to be monoinfected with HBV were collected by the Canadian HBV Network from existing clinical databases, with support from the National Microbiology Laboratory, Public Health Agency of Canada. Data were collected in all provinces with the exception of New Brunswick and Newfoundland and Labrador. We analyzed the data using parametric and nonparametric statistical methods, with a significance level of p < 0.05. RESULTS In the 9380 unique patient records reviewed, the median age was 48 years, and 5193 patients (55.4%) were male. Ethnicity information was available for 7858 patients, of whom 5803 (73.8%) were Asian, 916 (11.6%) were black and 914 (11.6%) were white. Most of those tested (5556/6796 [81.8%]) were negative for HBV e-antigen, and most of those with fibrosis data (3481/4260 [81.7%]) had minimal liver fibrosis, with more advanced fibrosis noted in older people (> 40 yr). Of the 980 patients with genotype data, 521 (53.2%) had genotype B or C infection. Most of the 9241 patients with known confirmed treatment status received tenofovir disoproxil fumarate (1655 [17.9%]), lamivudine (1434 [15.5%]) or entecavir (548 [5.9%]). INTERPRETATION Based on available data, Canadian patients with chronic hepatitis B are predominantly Asian and negative for HBV e-antigen, and have genotype B or C infection. Interprovincial variations were noted in antiviral treatment regimen. This multicentre nationwide study provides data regarding patients with chronic hepatitis B and may inform future studies on the epidemiologic features of HBV infection in Canada.
加拿大8个省慢性乙型肝炎病毒感染的流行病学和临床特征:加拿大HBV网络的描述性研究
加拿大已发表的乙型肝炎病毒(HBV)感染的流行病学数据包括单中心研究或集中于土著人口。我们进行了一项研究,以表征加拿大慢性乙型肝炎患者的人口统计学和临床特征、肝脏疾病状况和治疗。方法在这项描述性、机会性、横断面研究中,加拿大HBV网络在加拿大公共卫生署国家微生物学实验室的支持下,从现有临床数据库中收集已知单HBV感染者的可用数据。除新不伦瑞克省、纽芬兰和拉布拉多省外,所有省份都收集了数据。我们采用参数和非参数统计方法对数据进行分析,p < 0.05为显著性水平。结果9380例患者中位年龄为48岁,男性5193例,占55.4%。7858例患者获得种族信息,其中5803例(73.8%)为亚洲人,916例(11.6%)为黑人,914例(11.6%)为白人。大多数测试者(5556/6796 [81.8%])HBV e抗原呈阴性,大多数有纤维化数据的患者(3481/4260[81.7%])肝纤维化程度较轻,老年人(40岁)肝纤维化更严重。在980例有基因型数据的患者中,521例(53.2%)为基因型B或C感染。9241例已知治疗状态的患者中,大多数接受富马酸替诺福韦二氧吡酯(1655例[17.9%])、拉米夫定(1434例[15.5%])或恩替卡韦(548例[5.9%])治疗。根据现有数据,加拿大慢性乙型肝炎患者主要为亚洲人,HBV e抗原阴性,基因型为B型或C型感染。省际间抗病毒治疗方案存在差异。这项全国性的多中心研究提供了关于慢性乙型肝炎患者的数据,并可能为加拿大HBV感染的流行病学特征的未来研究提供信息。
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来源期刊
CiteScore
5.40
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