title: Missed treatment in an Italian HBV infected patients cohort: HBV RER.
abstract: OBJECTIVE
  Very little is known about the access to treatment for Chronic Hepatitis B in the real clinical practice and the characteristics of the patients who do not receive antiviral therapy.
  
  
  METHODS
  HBV-RER is an observational multicenter network that collected data of patients with HBV infection during a 3 years observational period (2009-2012).
  
  
  RESULTS
  Among 2527 HBsAg positive patients, 1099 were never treated (NT); only 280 were included in the analysis due to different exclusion causes A minority was HBeAg-positive. The median age was 42. At liver biopsy most patients had Metavir score of F0-F1. Univariate analysis between 280 NT patients and the 290 naïve to treatment showed that NT patients were mostly female (P=0.002), not Italian (P=0.044), younger (P<0.001). Metavir score was lower in NT (P0.002), such as the Fib4 score (P<0.001). HBV DNA level was significantly higher in NT. At multivariate analysis, independent variables associated with no-treatment were younger age, female gender, Metavir score F0-F1, Fib4 lower than 1.6 and lower blood level of HBV-DNA.
  
  
  CONCLUSIONS
  There is a large number of patients eligible to treatment who do not receive it. A younger age and a less severe disease seem to be associated to deferral of treatment.
authors: Infectious Disease, Azienda Ospedaliero Universitaria di Modena, Modena, Italy. Electronic address: gian.cuomo@gmail.com.
authors: Gianluca
authors: G
authors: Cuomo
authors: Infectious Disease, Azienda Ospedaliero Universitaria di Modena, Modena, Italy.
authors: Vanni
authors: V
authors: Borghi
authors: Internal Medicine, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy.
authors: Pietro
authors: P
authors: Andreone
authors: Infectious Disease, IRCCS - ASMN Reggio Emilia, Reggio Emilia, Italy.
authors: Marco
authors: M
authors: Massari
authors: Gastroenterology, Azienda Ospedaliero Universitaria di Modena, Italy.
authors: Erica
authors: E
authors: Villa
authors: Internal Medicine, Azienda Ospedaliero Universitaria Modena, Modena, Italy.
authors: Antonello
authors: A
authors: Pietrangelo
authors: Infectious Disease, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy.
authors: Gabriella
authors: G
authors: Verucchi
authors: Infectious Disease and Hepatology, Azienda Ospedaliero Universitaria di Parma, Parma, Italy.
authors: Carlo
authors: C
authors: Ferrari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood; D016208:Databases, Factual; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D007558:Italy; D008099:Liver / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D000410:Alanine Transaminase
keywords: HBV; Hepatitis B treatment; Liver fibrosis