Characteristics of patients with chronic hepatitis-B virus infection in an urban hospital.
BACKGROUND
In the United States, among patients with hepatocellular carcinoma (HCC) and portal hypertension from chronic hepatitis-B virus infection, 44% were Hispanic and 28% were African American. Because our institution (Bronx Lebanon Hospital Center, Bronx, NY) predominantly serves these populations, we studied retrospectively the characteristics of patients with chronic hepatitis-B virus infection.


METHODS
We reviewed the medical records of all patients aged > 18 years with chronic hepatitis-B virus infection who had been evaluated at our institution between January 1, 2002 and May 31, 2005.


RESULTS
We identified 167 patients with chronic hepatitis-B virus infection. Only 12 (7%) patients underwent chronic hepatitis-B virus treatment. One-hundred-forty-six (87%) patients without decompensated liver cirrhosis were not treated owing to the following reasons: normal alanine aminotransferase level (86%), active injection drug or heavy alcohol use (9%), lack of health insurance coverage (3%) and noncompliance with visits during the evaluation period (2%). HCC screening was performed in 78 patients (47%). Lack of insurance coverage and compliance issues were predictors for HCC screening (p = 0.04 and p < 0.001, respectively).


CONCLUSIONS
In the South Bronx, 87% patients were not considered candidates for hepatitis-B virus treatment because of normal alanine aminotransferase levels and the interference of potentially modifiable social factors. Only 47% of our patients with chronic hepatitis-B virus infection underwent HCC screening because of lack of insurance coverage and compliance issues.
Widjaja
David
D
Division of Gastroenterology, Bronx Lebanon Hospital Center, Bronx, NY 10457, USA.
Yarlagadda
Suresh
S
Singu
Bheema S
BS
Loganathan
Raghu S
RS
Blum
Steve
S
Bloom
Alan
A
Remy
Prospere
P
D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D000075202:Contraindications; D005260:Female; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology*; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage; D007372:Interferons / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000208:ethnology; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D063065:Organophosphonates / Q000627:therapeutic use; D010349:Patient Compliance / Q000208:ethnology*; D010865:Pilot Projects; D016079:Refusal to Treat; D012307:Risk Factors; D014504:Urban Health / Q000706:statistics & numerical data*; D014600:Utilization Review
D063065:Organophosphonates; D019259:Lamivudine; C053001:adefovir; D007372:Interferons; D000225:Adenine