scholarly journals PRO: Patients With Chronic Hepatitis B in Immune‐Tolerant Phase Should Be Treated

2020 ◽  
Vol 15 (1) ◽  
pp. 21-24
Author(s):  
Jagpal Singh Klair ◽  
James Vancura ◽  
Arvind R. Murali
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Immune Tolerant

Cost-effectiveness of antiviral treatment in adult patients with immune-tolerant phase chronic hepatitis B

Gut ◽  
2020 ◽  
pp. gutjnl-2020-321309 ◽  
Author(s):  
Hye-Lin Kim ◽  
Gi-Ae Kim ◽  
Jae-A Park ◽  
Hye-Rim Kang ◽  
Eui-Kyung Lee ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Cost Effectiveness ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Antiviral Treatment ◽  
Productivity Loss ◽  
Cost Effective ◽  
Hbv Dna ◽  
It Strategy ◽  
Immune Tolerant

ObjectiveThe cost-effectiveness of antiviral treatment in adult immune-tolerant (IT) phase chronic hepatitis B (CHB) patients is uncertain.DesignWe designed a Markov model to compare expected costs and quality-adjusted life-years (QALYs) of starting antiviral treatment at IT-phase (‘treat-IT’) vs delaying the therapy until active hepatitis phase (‘untreat-IT’) in CHB patients over a 20-year horizon. A cohort of 10 000 non-cirrhotic 35-year-old patients in IT-phase CHB (hepatitis B e antigen-positive, mean serum hepatitis B virus (HBV) DNA levels 7.6 log10 IU/mL, and normal alanine aminotransferase levels) was simulated. Input parameters were obtained from previous studies at Asan Medical Center, Korea. The incremental cost-effectiveness ratio (ICER) between the treat-IT and untreat-IT strategies was calculated.ResultsFrom a healthcare system perspective, the treat-IT strategy with entecavir or tenofovir had an ICER of US$16 516/QALY, with an annual hepatocellular carcinoma (HCC) incidence of 0.73% in the untreat-IT group. With the annual HCC risk ≥0.54%, the treat-IT strategy was cost-effective at a willingness-to-pay threshold of US$20 000/QALY. From a societal perspective considering productivity loss by premature death, the treat-IT strategy was extremely cost-effective, and was dominant (ICER <0) if the HCC risk was ≥0.43%, suggesting that the treat-IT strategy incurs less costs than the untreat-IT strategy. The most influential parameters on cost-effectiveness of the treat-IT strategy were those related with HCC risk (HBV DNA levels, platelet counts and age) and drug cost.ConclusionStarting antiviral therapy in IT phase is cost-effective compared with delaying the treatment until the active hepatitis phase in CHB patients, especially with increasing HCC risk, decreasing drug costs and consideration of productivity loss.

scholarly journals Author Correction: Comparison between chronic hepatitis B patients with untreated immune-tolerant phase vs. those with virological response by antivirals

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Hye Won Lee ◽  
Seung Up Kim ◽  
Oidov Baatarkhuu ◽  
Jun Yong Park ◽  
Do Young Kim ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Virological Response ◽  
Immune Tolerant

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

FRI-182-Anti-viral treatment in patients with immune tolerant-phase chronic hepatitis B may be cost-effective

2019 ◽  
Vol 70 (1) ◽  
pp. e469-e470
Author(s):  
Hye-Lin Kim ◽  
Gi-Ae Kim ◽  
Jae-A Park ◽  
Hye-Rim Kang ◽  
Eui-Kyung Lee ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Cost Effective ◽  
Immune Tolerant

Prognosis of immune-tolerant phase chronic hepatitis B

Gut ◽  
2017 ◽  
Vol 67 (5) ◽  
pp. 988.1-988 ◽  
Author(s):  
Chia-Ming Chu ◽  
Yun-Fan Liaw
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Immune Tolerant

scholarly journals Comparison between chronic hepatitis B patients with untreated immune-tolerant phase vs. those with virological response by antivirals

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Hye Won Lee ◽  
Seung Up Kim ◽  
Oidov Baatarkhuu ◽  
Jun Yong Park ◽  
Do Young Kim ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Virological Response ◽  
Immune Tolerant
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