Reports from SSAC Foundation grant recipients 2020

Bollerup, Signe. Decision sum: 50.000 SEK

Report: The aim of this project was to provide updated knowledge of the population with chronic HBV infection in Denmark to guide future efforts to achieve the elimination targets set by the world health organization and support clinical decisions on monitoring and HCC surveillance. This included examining the prevalence and treatment of chronic HBV infection, the mortality in individuals with chronic HBV infection compared with the general population and the incidence of long-term complications. Finally, we aimed to determine if the PAGE-B score might be useful for assessing hepatocellular carcinoma (HCC) risk in the population with chronic HBV in Denmark.
We found that 14,548 individuals had chronic HBV infection on December 31, 2016 corresponding to 0.3% of the population over the age of 16 in Denmark. Moreover, we estimated that 13,530 (93%) individuals were diagnosed. Among individuals diagnosed with chronic HBV infection, only 4,297 (32%) received specialized care, while merely 3,289 (24%) cases were reported to the HBV surveillance system. Among persons attending specialized care 84% of individuals eligible for antiviral treatment according to Danish national guidelines, initiated treatment. Compared with the general population the rate of death was 50% higher in individuals with chronic HBV infection. Rate of death from liver disease, external factors, endocrine disease, genitourinary disease and non-liver neoplasms were higher in persons with chronic HBV infection. We found low rates of HCC and decompensated liver cirrhosis among persons with chronic HBV infection. Among individuals who were hepatitis B e antigen (HBeAg) negative and had low HBV DNA and normal alanine aminotransferase (ALT) at baseline none under the age of 45 developed liver complications or initiated antiviral treatment due to liver disease progression. Finally, PAGE-B score showed reasonable discriminatory abilities for HCC risk.