title: Therapeutic management of chronic hepatitis B in clinical practice: a region-wide survey.
abstract: OBJECTIVE
  To characterize the clinical and treatment pattern in a large population of hepatitis B virus (HBV) patients managed at tertiary referral centers in clinical practice.
  
  
  BACKGROUND
  Successful treatment, either with interferon (IFN) or nucleos(t)ide analogs (NUCs), of chronic HBV infection is associated with improved long-term patient outcome. However, in clinical practice, the actual management of these patients is not well characterized, and data regarding treatment pattern in this setting are lacking.
  
  
  METHODS
  In this cross-sectional study, we evaluated 505 patients chronically infected with HBV alone and who had at least 1-year follow-up. We assessed indication to, rate of, and type of treatment as well as the characteristics of treated patients.
  
  
  RESULTS
  Overall prevalence of positivity for HBe antigen was 19.3%, and the majority of patients had chronic hepatitis (47.5%). Non-Italian patients represented approximately one third of the population (27.1%). Among patients with indication to antiviral therapy (n=318), treatment was actually carried out in 264 patients (83.0%), prevalently with NUCs (65.9%). IFN-treated patients were younger (P<0.001), more frequently male (P=0.025) and HBeAg positive (P=0.003), and less frequently cirrhotics (P<0.001) as compared with patients treated with NUCs.
  
  
  CONCLUSIONS
  In a geographical area with a low positivity for HBe antigen, antiviral therapy is actually carried out in the majority of patients who have indication to treatment, prevalently with NUCs, whereas IFN treatment is more frequently carried out in young, HBe antigen-positive patients who do not have advanced liver disease.
authors.affiliation: *Cattedra di Gastroenterologia, Dipartimento di Medicina Interna ‡Cattedra di Malattie Infettive, Dipartimento di Scienze della Salute, Università di Genova #Divisione di Medicina Interna, Ospedale Evangelico Internazionale, Presidio di Genova-Voltri §Divisione di Malattie Infettive, Ospedale Galliera, Genova †Divisione di Malattie Infettive, Ospedale Sant'Andrea, La Spezia ∥Divisione di Gastroenterologia ¶Divisione di Malattie Infettive, Ospedale San Paolo, Savona **Divisione di Malattie Infettive e Ortopedia Settica, Ospedale Santa Maria di Misericordia, Albenga, Italy.
authors.forename: Edoardo G
authors.initials: EG
authors.lastname: Giannini
authors.forename: Simona
authors.initials: S
authors.lastname: Marenco
authors.forename: Silvia
authors.initials: S
authors.lastname: Boni
authors.forename: Andrea
authors.initials: A
authors.lastname: Beltrame
authors.forename: Laura A
authors.initials: LA
authors.lastname: Nicolini
authors.forename: Lucia
authors.initials: L
authors.lastname: Taramasso
authors.forename: Marcello
authors.initials: M
authors.lastname: Feasi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Grasso
authors.forename: Pasqualina
authors.initials: P
authors.lastname: De Leo
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Percario
authors.forename: Valentina
authors.initials: V
authors.lastname: Bartolacci
authors.forename: Stefania
authors.initials: S
authors.lastname: Artioli
authors.forename: Claudio
authors.initials: C
authors.lastname: Viscoli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cassola
authors.forename: Roberto
authors.initials: R
authors.lastname: Testa
authors.forename: Marco
authors.initials: M
authors.lastname: Anselmo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Riccio
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Savarino
authors.forename: Antonino
authors.initials: A
authors.lastname: Picciotto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D019538:Health Care Surveys; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects* / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends*; D016036:Seroepidemiologic Studies; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D006513:Hepatitis B e Antigens; D007372:Interferons