Advancing age and comorbidity in a United States insured population-based cohort of patients with chronic hepatitis B. Hepatology (Baltimore, Md.) Nguyen, M. H., Lim, J. K., Ozbay, A. B., Fraysse, J., Liou, I., Meyer, N., Dusheiko, G., Gordon, S. C. 2018


Chronic hepatitis B (CHB) comorbidity data are limited. Using insurance claims databases, our aims were to determine the prevalence and incidence of non-liver comorbidities in CHB patients over time and the predictors of select comorbidities in CHB patients. Patients were adults with continuous coverage (Commercial/Medicare or Medicaid) 6 months prior to and after the first CHB diagnosis and matched non-CHB patients. Deyo-Charlson comorbidity index (DCCI) and comorbidities were analyzed (cardiovascular disease [CVD], carcinoma, diabetes [DM], obesity, hypertension [HTN], hyperlipidemia [HPL], alcohol use, renal impairment [RI], chronic kidney disease and [CKD]osteoporosis/fracture [OF]). Study population included 44,026 CHB cases and 121,568 matched controls. CHB patient mean age increased from 48.1±11.9 in 2006 to 51.8±12.4 years in 2015 for Commercial/Medicare and 44.1±11.1 to 50.2±10.2 years for Medicaid (P<0.001 for both). The Medicaid CHB cohort was the sickest (DCCI=2.6, P<0.001). The Commercial/Medicare 2006 CKD prevalence rate was 36.1/1000 in CHB and 10.2/1000 in controls, increasing to 97.6 and 38.8 in 2015, respectively. The 2006 CKD incidence (per 1,000 person-years) was 10.3 and 4.8; 15.2 and 11.3 by 2015, respectively (P<0.05 for all). Strongest predictors for CKD were: DM (HR: 2.48), HTN (HR: 3.29), and CVD (HR: 2.61) (all P<0.0001). Similar prevalence and incidence changes were observed for OF. Strongest predictors for OF were female (HR: 2.22), alcohol use (HR: 2.02), and viral coinfection (HR: 1.37) (all P<0.0001).CONCLUSION: Insured CHB patients were older with more comorbidities and experienced higher incidence and prevalence of CKD and OF than controls. This article is protected by copyright. All rights reserved.

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