Changing clinical care cascade of patients with chronic hepatitis B in Beijing, China

Background: High uptake of hepatitis B virus (HBV) tests and antiviral therapy are required to improve the clinical outcomes of patients with chronic hepatitis B (CHB) at the population level. In the current study, we used the Basic Medical Care Insurance for Employees (BMCIE) to investigate the cha...

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Autores principales:	Min Li, PhD, Lianhui Zhao, MD, Jialing Zhou, MSc, Yameng Sun, MD, Xiaoning Wu, MD, Xiaojuan Ou, MD, Hong You, MD, Yuanyuan Kong, PhD, Jidong Jia, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Chronic Hepatitis B Diagnosis Antiviral therapy Clinical care cascade Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/474df036d3d74390bd24256338bd6a8f
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spelling	oai:doaj.org-article:474df036d3d74390bd24256338bd6a8f2021-12-02T05:04:00ZChanging clinical care cascade of patients with chronic hepatitis B in Beijing, China2666-606510.1016/j.lanwpc.2021.100249https://doaj.org/article/474df036d3d74390bd24256338bd6a8f2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666606521001589https://doaj.org/toc/2666-6065Background: High uptake of hepatitis B virus (HBV) tests and antiviral therapy are required to improve the clinical outcomes of patients with chronic hepatitis B (CHB) at the population level. In the current study, we used the Basic Medical Care Insurance for Employees (BMCIE) to investigate the changes of clinical care cascade of CHB in Beijing, China. Methods: Records for medical service of CHB patients from January 1, 2010 to December 31, 2018 were retrieved from the BMCIE database. The annual and cumulative rates of CHB patients in care, receiving HBV tests and on antiviral therapy were calculated. The trends of annual percentage changes (APCs) were estimated using Joinpoint regression model. Findings: Among estimated HBsAg positive employees, the rate of CHB patients in care increased from 4•77% in 2010 to 18•61% in 2018 (APC=17•3, 95%CI: 14•4-20•4). The rate of HBV tests increased from 4•41% in 2010 to 16•39% in 2018. Among the estimated eligible employees for treatment, the rate of antiviral therapy increased from 3•92% in 2010 to 30•88% in 2018. The proportion of hospital visits for HBV≥4 times per year had increased from 47•07% in 2010 to 65•31% in 2018. By 2018, entecavir (65•07%) and tenofovir (12•98%) had become the predominantly prescribed antiviral agents. Interpretation: The rates of CHB patients in care, receiving HBV tests and on antiviral therapy substantially increased in Beijing, China. However, more efforts are still needed to increase the uptake of HBV tests and treatment for achieving the goal of HBV elimination by 2030. Funding: Beijing Municipal Science and Technology Commission (No.D161100002716003), National Science and Technology Major Special Project for Infectious Diseases (No.Z191100007619037, No.2018ZX10302204), and Digestive Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals (No. XXX 0104).Min Li, PhDLianhui Zhao, MDJialing Zhou, MScYameng Sun, MDXiaoning Wu, MDXiaojuan Ou, MDHong You, MDYuanyuan Kong, PhDJidong Jia, MDElsevierarticleChronic Hepatitis BDiagnosisAntiviral therapyClinical care cascadePublic aspects of medicineRA1-1270ENThe Lancet Regional Health. Western Pacific, Vol 16, Iss , Pp 100249- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Chronic Hepatitis B Diagnosis Antiviral therapy Clinical care cascade Public aspects of medicine RA1-1270
spellingShingle	Chronic Hepatitis B Diagnosis Antiviral therapy Clinical care cascade Public aspects of medicine RA1-1270 Min Li, PhD Lianhui Zhao, MD Jialing Zhou, MSc Yameng Sun, MD Xiaoning Wu, MD Xiaojuan Ou, MD Hong You, MD Yuanyuan Kong, PhD Jidong Jia, MD Changing clinical care cascade of patients with chronic hepatitis B in Beijing, China
description	Background: High uptake of hepatitis B virus (HBV) tests and antiviral therapy are required to improve the clinical outcomes of patients with chronic hepatitis B (CHB) at the population level. In the current study, we used the Basic Medical Care Insurance for Employees (BMCIE) to investigate the changes of clinical care cascade of CHB in Beijing, China. Methods: Records for medical service of CHB patients from January 1, 2010 to December 31, 2018 were retrieved from the BMCIE database. The annual and cumulative rates of CHB patients in care, receiving HBV tests and on antiviral therapy were calculated. The trends of annual percentage changes (APCs) were estimated using Joinpoint regression model. Findings: Among estimated HBsAg positive employees, the rate of CHB patients in care increased from 4•77% in 2010 to 18•61% in 2018 (APC=17•3, 95%CI: 14•4-20•4). The rate of HBV tests increased from 4•41% in 2010 to 16•39% in 2018. Among the estimated eligible employees for treatment, the rate of antiviral therapy increased from 3•92% in 2010 to 30•88% in 2018. The proportion of hospital visits for HBV≥4 times per year had increased from 47•07% in 2010 to 65•31% in 2018. By 2018, entecavir (65•07%) and tenofovir (12•98%) had become the predominantly prescribed antiviral agents. Interpretation: The rates of CHB patients in care, receiving HBV tests and on antiviral therapy substantially increased in Beijing, China. However, more efforts are still needed to increase the uptake of HBV tests and treatment for achieving the goal of HBV elimination by 2030. Funding: Beijing Municipal Science and Technology Commission (No.D161100002716003), National Science and Technology Major Special Project for Infectious Diseases (No.Z191100007619037, No.2018ZX10302204), and Digestive Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals (No. XXX 0104).
format	article
author	Min Li, PhD Lianhui Zhao, MD Jialing Zhou, MSc Yameng Sun, MD Xiaoning Wu, MD Xiaojuan Ou, MD Hong You, MD Yuanyuan Kong, PhD Jidong Jia, MD
author_facet	Min Li, PhD Lianhui Zhao, MD Jialing Zhou, MSc Yameng Sun, MD Xiaoning Wu, MD Xiaojuan Ou, MD Hong You, MD Yuanyuan Kong, PhD Jidong Jia, MD
author_sort	Min Li, PhD
title	Changing clinical care cascade of patients with chronic hepatitis B in Beijing, China
title_short	Changing clinical care cascade of patients with chronic hepatitis B in Beijing, China
title_full	Changing clinical care cascade of patients with chronic hepatitis B in Beijing, China
title_fullStr	Changing clinical care cascade of patients with chronic hepatitis B in Beijing, China
title_full_unstemmed	Changing clinical care cascade of patients with chronic hepatitis B in Beijing, China
title_sort	changing clinical care cascade of patients with chronic hepatitis b in beijing, china
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/474df036d3d74390bd24256338bd6a8f
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Changing clinical care cascade of patients with chronic hepatitis B in Beijing, China

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