title: Hepatitis B virus and hepatitis C virus infections in Belgium: similarities and differences in epidemics and initial management.
abstract: BACKGROUND
  Nationwide studies comparing patients with hepatitis B and C virus (HBV and HCV) infections are mandatory for assessing changes in epidemiology.
  
  
  OBJECTIVE
  The aim of this study was to compare epidemiological data and initial management of newly diagnosed patients with persistent HBV (HBsAg positive) or HCV (detectable HCV RNA) infection in Belgium.
  
  
  METHODS
  Data were extracted from two Belgian observational databases.
  
  
  RESULTS
  A total of 655 patients (387 HBV and 268 HCV) were included. Compared with HCV patients, HBV patients were younger, more frequently men, more often of Asian or African origin (43 vs. 10%, P<0.0001), and less frequently contaminated by transfusion or intravenous drug use (9 and 6% vs. 34 and 44%, P<0.0001). Viral replication was assessed in 89% of HBV patients. Compared with HCV patients, HBV patients more frequently had normal alanine aminotransferase (ALT) levels (65 vs. 29%, P<0.0001), less frequently underwent liver biopsy (29 vs. 67%, P<0.0001), and were less often considered for antiviral therapy (25 vs. 54%, P<0.0001). When taking only HBV patients with detectable viral replication into consideration, results remained unchanged. During the multivariate analysis, ALT was a major factor for performing liver biopsy or considering antiviral therapy in both groups.
  
  
  CONCLUSIONS
  HBV and HCV screening policies should be targeted toward immigrants and intravenous drug users, respectively. Guidelines recommending systematic search for viral replication should be reinforced in HBV patients. HBV patients less frequently underwent liver biopsy and were less often considered for antiviral therapy compared with HCV patients. Despite the lack of sensitivity and specificity, ALT remains a pivotal decision-making tool for liver biopsy and antiviral therapy in both infections.
authors: Department of Hepatogastroenterology, Hôpital de Jolimont, Haine-Saint-Paul, Belgium.
authors: Bénédicte
authors: B
authors: De Vroey
authors: Christophe
authors: C
authors: Moreno
authors: Wim
authors: W
authors: Laleman
authors: Marc
authors: M
authors: van Gossum
authors: Isabelle
authors: I
authors: Colle
authors: Chantal
authors: C
authors: de Galocsy
authors: Philippe
authors: P
authors: Langlet
authors: Geert
authors: G
authors: Robaeys
authors: Hans
authors: H
authors: Orlent
authors: Peter
authors: P
authors: Michielsen
authors: Jean
authors: J
authors: Delwaide
authors: Hendrik
authors: H
authors: Reynaert
authors: François
authors: F
authors: D'Heygere
authors: Dirk
authors: D
authors: Sprengers
authors: Stefan
authors: S
authors: Bourgeois
authors: Collins
authors: C
authors: Assene
authors: Bertrand
authors: B
authors: Vos
authors: Réginald
authors: R
authors: Brenard
authors: Michael
authors: M
authors: Adler
authors: Jean
authors: J
authors: Henrion
authors: Pierre
authors: P
authors: Deltenre
mesh_terms: D000328:Adult; D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D001530:Belgium / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002353:Carrier State / Q000453:epidemiology; D058872:Epidemics; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000502:physiology; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D019562:Viral Load; D014779:Virus Replication
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D006514:Hepatitis B Surface Antigens; D000410:Alanine Transaminase