Diapositive 1

1
Are newly diagnosed patients with HBV and HCV
infection different ?Comparison between 2
prospective registries of the Belgian Association
for the Study of the Liver
Bénédicte De Vroey1, Christophe Moreno2, Wim
Laleman3, Marc van Gossum4, Isabelle Colle5,
Chantal de Galocsy6, Philippe Langlet7, Geert
Robaeys8, Hans Orlent9, Peter Michielsen10, Jean
Delwaide11, Hendrik Reynaert12, Michael Adler2,
Jean Henrion1, Pierre Deltenre1 1 Hôpital de
Jolimont, Haine-Saint-Paul, Belgium, 2 Hôpital
Erasme, Brussels, Belgium, 3 KUL Leuven, Belgium,
4 CHU Saint-Pierre, Brussels, Belgium, 5 UZ,
Gent, Belgium, 6 Hôpitaux Iris Sud Bracops,
Brussels, Belgium, 7 CHU Brugmann, Brussels,
Belgium, 8 Ziekenhuis Oost-Limburg, Genk,
Belgium, 9 AZ St Jan, Brugge, Belgium, 10 UZ
Antwerpen, Edegem, Belgium, 11 CHU, Liège,
Belgium, 12 UZ, Brussels, Belgium The authors
have no financial disclosure related to this
study
Summary
Introduction
Introduction Hepatitis B (HBV) and C (HCV)
infections share many epidemiological and
clinical similarities but exhibit also important
differences. Moreover, their epidemiological
characteristics are evolving in western
countries. Nationwide studies comparing
representative samples of patients newly
diagnosed with HBV or HCV infections have not
been reported. Aim To compare the main
epidemiological, biological and histological
characteristics of patients with newly diagnosed
HBV or HCV infection in Belgium, and to compare
their management. Methods Data of patients with
newly diagnosed HBV or HVC infection were
extracted from two Belgian registries (HBsAg
carriers registry, 2008-2009 and observational
survey of hepatitis C, 2003-2004). Results 705
patients (387 with HBV and 318 with HCV) were
included. Compared to HCV patients, HBV patients
were younger (36 vs. 44 years, plt0.0001), more
frequently male (69 vs. 56, plt0.0003), less
frequently of Caucasian origin (43 vs. 86,
plt0.0001), more frequently black Africans (32 vs.
9, plt0.0001), less frequently contaminated by
transfusion or IV drug use (9 and 6 vs. 33 and
43, respectively, plt0.0001), more frequently
contaminated by sexual or familial transmission
(40 and 30 vs. 1 and 1 respectively, plt0.0001).
HBV patients had higher rates of normal ALT (65
vs. 36, plt0.0001), lower rates of ALT gt2ULN (15
vs. 38, plt0.0001), and lower rates of detectable
viral nucleic acid by PCR (70 vs. 84, plt0.0001)
than HCV patients. A liver biopsy was performed
in 303 patients (in 29 of HBV patients and in
61 of HCV patients, plt0.0001). Twenty-five
percents of the patients had extensive fibrosis
or cirrhosis (F3/4) (32 of HBV patients, 21 of
HCV patients, p0.04). In multivariate analysis,
significant predictors of F3/4 were older age
(p0.003), male sex (p0.02), HBV infection
(p0.03), ALT gt2ULN (p0.01) and activity score
gt2 (p0.004). HBV patients were less frequently
considered for treatment (25 vs. 47, plt0.0001)
than HCV patients. Conclusions Newly diagnosed
HBV and HCV patients disclosed different
epidemiological characteristics that should be
taken into account for screening. Management of
HBV and HCV patients differed, HBV patients
undergoing less frequently a liver biopsy and
being less frequently considered for treatment..
Hepatitis B (HBV) and C (HCV) infections share
many epidemiological and clinical similarities
but exhibit also important differences. Moreover,
their epidemiological characteristics are
evolving in western countries. Nationwide studies
comparing representative samples of patients
newly diagnosed with HBV or HCV infections have
not been reported.
Aim
Patients
To compare the main epidemiological, biological
and histological characteristics of patients with
newly diagnosed HBV or HCV infection in Belgium
and to compare their management.
HBV patients n387 HCV patients n318 p value
Mean age (years) 36 44 lt0.0001
Sex ratio (men/women) 69 / 31 56 / 44 lt0.0003
Origin
Caucasian 43 86 lt0.0001
Black African 32 9 lt0.0001
Other 25 5 lt0.0001
Risk factors for infection
Transfusion 9 33 lt0.0001
IV drug use 6 43 lt0.0001
Sexual behavior 40 1 lt0.0001
Familial transmission 30 1 lt0.0001
Methods
Data of patients with newly diagnosed HBV or HCV
infection were extracted from two Belgian
registries (HBsAg carriers registry, 2008-2009
and observational survey of hepatitis C,
2003-2004).
Histological parameters and management
Biological parameters
Predictors of F3/4 in multivariate analysis
Older age p0.003 Male sex p0.02 HBV
infection p0.03 ALTgt2ULN p0.01 Activity score
gt2 p0.004
Conclusions
1/ In Belgium, newly diagnosed HBV and HCV
patients disclose different epidemiological
characteristics that should be taken into account
for screening. 2/ Management of HBV and HCV
patients also differs, HBV patients undergoing
less frequently a liver biopsy and being less
frequently considered for treatment.