scholarly journals The trend of direct medical costs and associated factors in patients with chronic hepatitis B in Guangzhou, China: an eight-year retrospective cohort study

2021 ◽  
Vol 21 (S2) ◽  
Author(s):  
Shuo Yang ◽  
Ge Chen ◽  
Yueping Li ◽  
Guanhai Li ◽  
Yingfang Liang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis B ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Medical Insurance ◽  
Medical Costs ◽  
Direct Medical Costs ◽  
B Virus ◽  
The Cost

Abstract Background Although the expenses of liver cirrhosis are covered by a critical illness fund under the current health insurance program in China, the medical costs associated with hepatitis B virus (HBV) related diseases is not well addressed. In order to provide evidence to address the problem, we investigated the trend of direct medical costs and associated factors in patients with chronic HBV infection. Methods A retrospective cohort study of 65,175 outpatients and 12,649 inpatients was conducted using a hospital information system database for the period from 2008 to 2015. Generalized estimating equations (GEE) were applied to explore associations between annual direct medical costs and corresponding factors, meanwhile quantile regression models were used to evaluate the effect of treatment modes on different quantiles of annual direct medical costs stratified by medical insurances. Results The direct medical costs increased with time, but the proportion of antiviral costs decreased with CHB progression. Antiviral costs accounted 54.61% of total direct medical costs for outpatients, but only 6.17% for inpatients. Non-antiviral medicine costs (46.06%) and lab tests costs (23.63%) accounted for the majority of the cost for inpatients. The direct medical costs were positively associated with CHB progression and hospitalization days in inpatients. The direct medical costs were the highest in outpatients with medical insurance and in inpatients with free medical service, and treatment modes had different effects on the direct medical costs in patients with and without medical insurance. Conclusions CHB patients had a heavy economic burden in Guangzhou, China, which increased over time, which were influenced by payment mode and treatment mode.

scholarly journals Infection deteriorating hepatitis B virus related acute-on-chronic liver failure: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xing-Ran Zhai ◽  
Jing-Jing Tong ◽  
Hong-Min Wang ◽  
Xiang Xu ◽  
Xiu-Ying Mu ◽  
...  
Keyword(s):  
Septic Shock ◽  
Cohort Study ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
B Virus

Abstract Background Infection is common in acute-on-chronic liver failure (ACLF), which may worsen the clinical condition and prognosis. However, the characteristics of infection and its influence on prognosis in hepatitis B virus related ACLF (HBV-ACLF) as defined by the European Association for the Study of the Liver (EASL) have not been clarified. We aimed to investigate the characteristics of infection and its influence on mortality in patients with HBV-ACLF defined by EASL in China. Methods We performed a retrospective cohort study in patients with HBV-ACLF defined by EASL in a single center from January 2015 to December 2017. These patients were divided into two groups with and without infection. The incidence, sites of infection, isolated strains, and risk factors associated with mortality were evaluated. Results A total of 289 patients were included, among them 185 (64.0%) were diagnosed with an infection. The most common type of infection was pneumonia (55.7%), followed by spontaneous bacterial peritonitis (47.6%) and others. The gram-negative bacteria were the most frequent (58.3%). Patients with one, two, and three or more infection sites had a gradually increasing incidence of sepsis (P < 0.01), septic shock (P < 0.001), and ACLF-3 (P < 0.05). Also, patients with infection isolated one, two, and three or more strains showed a growing incidence of sepsis (P < 0.01) and septic shock (P < 0.001). Patients with infection showed a significantly higher 28-day mortality than those without (P < 0.01), especially in patients with ACLF-3. Infection was identified as an independent risk factor for 28-day mortality in all HBV-ACLF patients. Pneumonia and sepsis were identified as independent predictors of 28-day mortality for patients with infection. Conclusions Infection is associated with severe clinical course and high mortality in HBV-ACLF defined by EASL. The increased number of infection sites or isolated strains was associated with the occurrence of sepsis and septic shock. Pneumonia and sepsis were independent predictors for mortality in HBV-ACLF patients with infection.

scholarly journals Molecular epidemiology of hepatitis B virus infection in Switzerland: a retrospective cohort study

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Cédric Hirzel ◽  
Gilles Wandeler ◽  
Marta Owczarek ◽  
Meri Gorgievski-Hrisoho ◽  
Jean-Francois Dufour ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis B Virus ◽  
Virus Infection ◽  
Hepatitis B ◽  
Molecular Epidemiology ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hepatitis B Virus Infection ◽  
B Virus

scholarly journals Infection deteriorating hepatitis B virus related acute-on-chronic liver failure: a retrospective cohort study

2020 ◽  
Author(s):  
Xing-Ran Zhai ◽  
Jing-Jing Tong ◽  
Hong-Min Wang ◽  
Xiang Xu ◽  
Xiu-Ying Mu ◽  
...  
Keyword(s):  
Septic Shock ◽  
Cohort Study ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
B Virus

Abstract Background: Infection is common in acute-on-chronic liver failure (ACLF), which may worsen the clinical condition and prognosis. However, the characteristics of infection and its influence on prognosis in hepatitis B virus related ACLF (HBV-ACLF) as defined by the European Association for the Study of the Liver (EASL) have not been clarified. We aimed to investigate the characteristics of infection and its influence on mortality in patients with HBV-ACLF defined by EASL in China.Methods: We performed a retrospective cohort study in patients with HBV-ACLF defined by EASL in a single center from January 2015 to December 2017. These patients were divided into two groups with and without infection. The incidence, sites of infection, isolated strains, and risk factors associated with mortality were evaluated. Results: A total of 289 patients were included, among them 185 (64.0%) were diagnosed with an infection. The most common type of infection was pneumonia (55.7%), followed by spontaneous bacterial peritonitis (47.6%) and others. The gram-negative bacteria were the most frequent (58.3%). Patients with one, two, and three or more infection sites had a gradually increasing incidence of sepsis (P<0.01), septic shock (P<0.001), and ACLF-3 (P<0.05). Also, patients with infection isolated one, two, and three or more strains showed a growing incidence of sepsis (P<0.01) and septic shock (P<0.001). Patients with infection showed a significantly higher 28-day mortality than those without (P<0.01), especially in patients with ACLF-3. Infection was identified as an independent risk factor for 28-day mortality in all HBV-ACLF patients. Pneumonia and sepsis were identified as independent predictors of 28-day mortality for patients with infection.Conclusions: Infection is associated with severe clinical course and high mortality in HBV-ACLF defined by EASL. The increased number of infection sites or isolated strains was associated with the occurrence of sepsis and septic shock. Pneumonia and sepsis were independent predictors for mortality in HBV-ACLF patients with infection.

scholarly journals Infection deteriorating hepatitis B virus related acute-on-chronic liver failure: a retrospective cohort study

2020 ◽  
Author(s):  
Xing-Ran Zhai ◽  
Jing-Jing Tong ◽  
Hong-Min Wang ◽  
Xiang Xu ◽  
Xiu-Ying Mu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Infection Group ◽  
B Virus

Abstract Background: Infection is common in acute-on-chronic liver failure (ACLF), which may worsen the clinical condition and prognosis. However, the characteristics of infection and its influence on prognosis in hepatitis B virus related ACLF (HBV-ACLF) as defined by the European Association for the Study of the Liver (EASL) have not been clarified. We aimed to investigate the characteristics of infection and its influence on mortality in HBV-ACLF defined by EASL in China.Methods: We performed a retrospective cohort study with HBV-ACLF patients defined by EASL in a single center from January 2015 to December 2017. Patients were divided into an infection group and a non-infection group. The incidence, sites, strains of infection, and risk factors for mortality were evaluated. Results: A total of 289 patients were included, of which 185 (64.0%) were diagnosed with an infection. The most common was pneumonia (55.7%), followed by spontaneous bacterial peritonitis (47.6%) and others. The gram-negative bacteria were the most frequent (58.3%). Patients with one, two, and three or more infection sites had a gradually increasing incidence of sepsis (P<0.01), sepsis shock (P<0.001), and ACLF-3 (P<0.05). One, two, and three or more strains were isolated in 86, 16, and 18 patients, who showed a growing incidence of sepsis (P<0.01) and sepsis shock (P<0.001). Infection was identified as an independent risk factor for 28-day mortality in HBV-ACLF patients. Infected patients showed a significantly higher 28-day mortality than those without (P<0.01), especially in patients with ACLF-3. Pneumonia and sepsis were identified as independent predictors of 28-day mortality for infected patients.Conclusions: Infection is associated with severe clinical course and high mortality in HBV-ACLF defined by EASL. The increased incidence of sepsis and sepsis shock was associated with an increased number of infection sites and isolated strains. Pneumonia and sepsis were independent predictors affecting mortality in HBV-ACLF patients with infection.

Risk of Onset of Hematological Malignancies in Patients Infected with the Hepatitis B Virus: Results from a Large-Scale Retrospective Cohort Study in China

2017 ◽  
Vol 137 (4) ◽  
pp. 209-213 ◽  
Author(s):  
Xiaoyang Li ◽  
Yu Zheng ◽  
Hongming Zhu ◽  
Xiaojing Lin ◽  
Yunxiang Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Large Scale ◽  
Hematological Malignancies ◽  
Core Antigen ◽  
Increased Risk ◽  
B Virus

The hepatitis B virus (HBV) is a major global issue, because an increased risk of hepatocellular carcinoma among patients infected with HBV is well established. Recently, it has been suggested that HBV is associated with other human cancers. However, the association between HBV and the risk of onset of hematological malignancies remains controversial. The aim of this large-scale retrospective cohort study was to evaluate the association between HBV infection and hematological malignancies. A retrospective analysis of 86,115 newly admitted patients at Shanghai Ruijin Hospital was performed. A cohort of patients previously exposed to HBV (n = 1,874) and a cohort of individuals without a positive test for anti-hepatitis B core antigen (anti-HBc; n = 45,118) were compared to assess the risk of hematological malignancies. Anti-HBc was positive in 61.2% cases and 54.3% controls (p = 0.0001). The risk of B cell non-Hodgkin's lymphoma, acute lymphoblastic leukemia, and multiple myeloma was higher in the HBV-infected cohort than in the non-HBV-infected cohort. In conclusion, patients infected with HBV have a substantially increased risk of hematological malignancies.

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