title: Trends in waiting list registration for liver transplantation for viral hepatitis in the United States.
abstract: OBJECTIVE
  In the last decade, significant progress has been made in the treatment of liver disease associated with chronic hepatitis, especially in patients infected with the hepatitis B virus (HBV). To investigate whether the population-wide application of antiviral therapies has impacted liver transplant waiting list registration, we analyzed longitudinal trends in waiting list registration for patients with hepatitis B and C and those with nonviral liver disease.
  
  
  METHODS
  This study represented a retrospective analysis of registry data containing all US liver transplant centers. All adult, primary liver transplantation candidates registered to the Organ Procurement and Transplantation Network between 1985 and 2006 were included in the analysis. Standardized incidence rates were calculated for waiting list registration for liver transplantation by underlying disease (HBV and HCV infection and other) and by indication for transplantation (fulminant liver disease, hepatocellular carcinoma [HCC], and end-stage liver disease [ESLD]).
  
  
  RESULTS
  Of 113,927 unique waiting list registrants, 4793 (4.2%) had HBV, and 40,923 (35.9%) had HCV infections; the remaining 68,211 (59.9%) had neither. The incidence of waiting list registration for ESLD and fulminant liver disease decreased, whereas that for HCC increased. The decrease in ESLD registration was most pronounced, and the increase in HCC was least dramatic among registrants with hepatitis B. The decrease in registration for ESLD secondary to HCV infection was also significantly larger than that for ESLD patients with nonviral etiologies.
  
  
  CONCLUSIONS
  The pattern of liver transplantation waiting list registration among patients with hepatitis B suggests that the widespread application of oral antiviral therapy for HBV contributed to the decreased incidence of decompensated liver disease.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. kim.ray@mayo.edu
authors.forename: W Ray
authors.initials: WR
authors.lastname: Kim
authors.forename: Norah A
authors.initials: NA
authors.lastname: Terrault
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Pedersen
authors.forename: Terry M
authors.initials: TM
authors.lastname: Therneau
authors.forename: Erick
authors.initials: E
authors.lastname: Edwards
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Hindman
authors.forename: Carol L
authors.initials: CL
authors.lastname: Brosgart
mesh_terms: D000328:Adult; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D017093:Liver Failure / Q000453:epidemiology / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D009927:Tissue and Organ Procurement / Q000458:organization & administration; D014481:United States / Q000453:epidemiology; D014850:Waiting Lists