OP-3 ASSESSING TREATMENT ELIGIBILITY EXPANSION UNDER THE 2024 WHO GUIDELINES FOR CHRONIC HEPATITIS B

No The 2024 WHO guidelines for chronic hepatitis B (CHB) aim to expand and simplify treatment eligibility, but these criteria have not been assessed. We aimed to estimate treatment eligibility and uptake according to country-specific guidelines and evaluate potential treatment expansion based on the WHO guidelines. This cross-sectional study included consecutive treatment-naïve CHB patients from Argentina, Brazil, Chile, and Uruguay who were referred for the first time to hepatology evaluation between January 2010 and June 2024. Treatment candidacy was evaluated according to both country-specific and WHO guidelines. We then estimated the difference in treatment candidacy between these two approaches. A total of 719 patients with CHB had complete data available to evaluate treatment candidacy according to both guidelines. Of these patients, 67% were male with a median age of 52 years (IQR 38-62), and 8.1% presented with liver decompensation. Among patients, 64% were HBeAg-negative, median HBV DNA level was 43,000 IU/ml (IQR 633-110,000,000 IU/ml), median ALT was 41 U/L (IQR 23-99 U/L), and 47% had an APRI >0.5. According to country-specific guidelines, 57% (95% CI: 53-60) met criteria for treatment. Antiviral treatment was initiated in 84% of eligible patients, primarily with entecavir (63%) and tenofovir (32%). Compared to country-specific guidelines, the proportion of patients meeting treatment criteria under the WHO guidelines increased to 67% (95% CI: 63.8-70.6), resulting in a 10% (95% CI: 8-13) increase in treatment candidacy (table). Treatment expansion was higher in women (15%; 95% CI: 10-20) than in men (8%; 95% CI: 5-11). According to WHO guidelines, a considerable proportion of CHB patients who do not meet country-specific criteria are eligible for antiviral therapy. Notably, treatment expansion is higher in women. Implementing WHO criteria can enhance treatment rates and advance efforts toward CHB elimination.

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Publication Details

Journal
Annals of Hepatology
Published
2024-12-01
DOI
https://doi.org/10.1016/j.aohep.2024.101601
Primary Topic
Hepatitis C virus research
Type
article
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article

OP-3 ASSESSING TREATMENT ELIGIBILITY EXPANSION UNDER THE 2024 WHO GUIDELINES FOR CHRONIC HEPATITIS B

Victoria Mainardi, Patrícia Momoyo Zitelli, Alexandre de Araújo, Fernando Gruz et al.
Annals of Hepatology
Hepatitis C virus research
article

OP-3 ASSESSING TREATMENT ELIGIBILITY EXPANSION UNDER THE 2024 WHO GUIDELINES FOR CHRONIC HEPATITIS B

Victoria Mainardi, Patrícia Momoyo Zitelli, Alexandre de Araújo, Fernando Gruz, Nelia Hernández, Jaime Poníachik, Gabriel Mezzano, Daniela Chiodi, Hugo Cheinquer, Melisa Dirchwolf, Fernando Bessone, Manuel Mendizábal, Ezequiel Ridruejo, Mário Guimarães Pessôa, Sebastián Marciano, Margarita Anders, Diego Hernan Giunta, Alejandro Soza, Fernando Cairo, Daniela Simian, Esteban González Ballerga, Constanza D. Sabate, Lucia Navarro, G Vergara, Marcelo Silva, Herman Aguirre, Melina Susana, Luis Rondeau, Grabriel Rifrani, Carla Enrique, Eugenia Labaronnie, Antonella Olivetti
article en

Abstract

No The 2024 WHO guidelines for chronic hepatitis B (CHB) aim to expand and simplify treatment eligibility, but these criteria have not been assessed. We aimed to estimate treatment eligibility and uptake according to country-specific guidelines and evaluate potential treatment expansion based on the WHO guidelines. This cross-sectional study included consecutive treatment-naïve CHB patients from Argentina, Brazil, Chile, and Uruguay who were referred for the first time to hepatology evaluation between January 2010 and June 2024. Treatment candidacy was evaluated according to both country-specific and WHO guidelines. We then estimated the difference in treatment candidacy between these two approaches. A total of 719 patients with CHB had complete data available to evaluate treatment candidacy according to both guidelines. Of these patients, 67% were male with a median age of 52 years (IQR 38-62), and 8.1% presented with liver decompensation. Among patients, 64% were HBeAg-negative, median HBV DNA level was 43,000 IU/ml (IQR 633-110,000,000 IU/ml), median ALT was 41 U/L (IQR 23-99 U/L), and 47% had an APRI >0.5. According to country-specific guidelines, 57% (95% CI: 53-60) met criteria for treatment. Antiviral treatment was initiated in 84% of eligible patients, primarily with entecavir (63%) and tenofovir (32%). Compared to country-specific guidelines, the proportion of patients meeting treatment criteria under the WHO guidelines increased to 67% (95% CI: 63.8-70.6), resulting in a 10% (95% CI: 8-13) increase in treatment candidacy (table). Treatment expansion was higher in women (15%; 95% CI: 10-20) than in men (8%; 95% CI: 5-11). According to WHO guidelines, a considerable proportion of CHB patients who do not meet country-specific criteria are eligible for antiviral therapy. Notably, treatment expansion is higher in women. Implementing WHO criteria can enhance treatment rates and advance efforts toward CHB elimination.

Annals of HepatologyVol. 29
National University of General San Martín (AR), Hospital Italiano de Buenos Aires (AR), Hospital del Salvador (CL), Hospital Universitario Austral (AR), Hospital Clínico de la Universidad Católica (CL), Hospital Provincial de Rosario (AR), Hospital de Clínicas "José de San Martín" (AR), Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (AR), Hospital Alemán (AR), Universidad San Pablo (MX), Hospital El Cruce (AR), Hospital Privado (AR), Hospital de Clínicas (UY), University of Chile (CL), University of Rio Grande and Rio Grande Community College (US)
Good health and well-being
Openalex Percentile: Top 65%
Hepatitis C virus research
DOIOpen Access PDFOpenAlex
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