Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Guideline Adherence for Treatment of Chronic HBV

Clin Gastroenterol Hepatol; ePub 2018 Oct 13; Nguyen, et al

In patients receiving care for chronic hepatitis B virus (HBV) infection, rates of evaluation and treatment were suboptimal in all practice settings, a recent study found. The study population comprised 4,130 consecutive, treatment-naïve patients with chronic HBV infection seen by primary care physicians (n=616), community gastroenterologists (n=2,251), or university hepatologists (n=1,263). Treatment eligibility was assessed using data from the first 6 months after initial presentation based on the American Association for the Study of Liver Diseases (AASLD) criteria adjusted for changes over time. Researchers found:

  • The proportions of patients evaluated by all 3 relevant tests within the first 6 months of care were: 36.69% in community primary care, ~60.0% in gastroenterologist care, and nearly 80.0% in hepatology care.
  • Higher proportions of patients were eligible for treatment in specialty practices.
  • There was no significant difference in the proportions of patients who began antiviral therapy between those receiving treatment from a gastroenterologist vs a hepatologist.
  • Of 243 evaluable patients receiving community primary care, only 31 were eligible for treatment and just 12 (38.71%) of these received treatment.

Citation:

Nguyen WH, Le AK, Trinh HN, et al. Poor adherence to guidelines for treatment of chronic HBV infection at primary care and referral practices. [Published online ahead of print October 13, 2018]. Clin Gastroenterol Hepatol. doi:10.1016/j.cgh.2018.10.012.

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