Cascade of care among people with hepatitis B in New South Wales, Australia.
J Viral Hepat
; 30(12): 926-938, 2023 12.
Article
em En
| MEDLINE
| ID: mdl-37553801
ABSTRACT
Hepatitis B virus (HBV) care cascade characterisation is important for monitoring HBV elimination progress. This study evaluated care cascade and factors associated with HBV DNA testing and treatment in New South Wales, Australia. HBV care cascade were determined through linkage of HBV notifications (1993-2017) to Medicare and pharmaceutical benefits schemes (2010-2018). Timely HBV DNA testing was within 4 weeks of HBV notification. Multivariate Cox proportional hazards regression evaluated factors associated with HBV DNA testing and treatment. Among 15,202 people with HBV notification, 10,479 (69%) were tested for HBV DNA. A total of 3179 (21%) initiated HBV treatment. HBV DNA testing was more likely among age ≥45 years (adjusted hazard ratio [aHR] 1.07, 95% CI 1.02, 1.12), hepatocellular carcinoma (HCC) (aHR 1.23, 95% CI 1.01, 1.50), coinfection (aHR 1.61, 95% CI 1.23, 2.09), later notification (2014-2017) (aHR 1.21, 95% CI 1.16, 1.26) and less likely among females (aHR 0.95, 95% CI 0.91, 0.99), history of alcohol use disorder (AUD) (aHR 0.77, 95% CI 0.66, 0.89), HCV coinfection (aHR .62, 95% CI 0.55, 0.70) and Indigenous peoples (aHR 0.84, 95% CI 0.71, 0.98). HBV treatment was associated with age ≥45 years (aHR 1.35, 95% CI 1.24, 1.48), decompensated cirrhosis (aHR 2.07, 95% CI 1.62, 2.65), HCC (aHR 2.96, 95% CI 2.35, 3.74), HIV coinfection (aHR 4.27, 95% CI 3.43, 5.31) and later notification (2014-2017) (aHR 1.37, 95% CI 1.26, 1.47). HBV treatment was less likely among females (aHR 0.68, 95% CI 0.63, 0.73) and Indigenous peoples (aHR 0.58, 95% CI 0.42, 0.80). HBV DNA testing and treatment coverage have increased, but remain sub-optimal among some key populations.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Carcinoma Hepatocelular
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Coinfecção
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Hepatite B
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Neoplasias Hepáticas
Limite:
Aged
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Female
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Humans
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Middle aged
País/Região como assunto:
Oceania
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article