{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T07:11:18Z","timestamp":1767856278324,"version":"3.49.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T00:00:00Z","timestamp":1708041600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,2,16]]},"abstract":"<jats:p>Chronic hepatitis B (CHB) infection affects approximately 90 million people in China, where there are profoundly unmet clinical and public health needs. This study evaluated patient demographics, disease progression, and treatment management using national administrative claims data. This retrospective, observational study used anonymized data from the China Health Insurance Research Association claims database (January 1\u2013December 31, 2016); data that could not be validated, or from duplicate entries, were excluded. Patients were identified using the International Classification of Diseases, 10th Revision diagnostic code for CHB (B18.0 and B18.1), using keyword searches for \u201cCHB or HBV\u201d and free-text descriptions of CHB treatments including nucleos(t)ide analogues. Primary objectives included evaluation of: demographics and clinical characteristics of patients with CHB, overall and by presence or absence of cirrhosis and hospital tier; proportion of patients prescribed CHB treatment; and healthcare costs and utilization overall and by presence or absence of cirrhosis and hospital tier. Most identified patients with CHB were male, aged 25 to 65 years, resided in East China, and had employee health insurance. Cirrhosis was common (16.20%) and associated with male preponderance, older age, hepatitis C virus coinfection, and higher hospital care demands and costs. The most frequently visited hospitals were Tier III; patients visiting Tier III generally required more hospital care compared with those visiting Tier I\/II hospitals. Only two-thirds of patients were prescribed antiviral therapy for CHB (most commonly nucleos(t)ide analogues). Results from this study highlight a substantial need to improve access to appropriate CHB treatment in China.<\/jats:p>","DOI":"10.1097\/md.0000000000036645","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T19:04:34Z","timestamp":1708110274000},"page":"e36645","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics of patients with chronic hepatitis B infection in China: A retrospective claims database study"],"prefix":"10.1097","volume":"103","author":[{"given":"Xing","family":"Meng","sequence":"first","affiliation":[{"name":"GSK, Institute for Infectious Diseases and Public Health, Beijing, China"},{"name":"Present address: Sinovac Biotech Co., Ltd, Clinical Research Department, Beijing, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2265-9506","authenticated-orcid":false,"given":"Iain A.","family":"Gillespie","sequence":"additional","affiliation":[{"name":"GSK, Epidemiology, Stevenage, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Dong","sequence":"additional","affiliation":[{"name":"GSK, Institute for Infectious Diseases and Public Health, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Ning","sequence":"additional","affiliation":[{"name":"School of Public Health, Hainan Medical University, Haikou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Kendrick","sequence":"additional","affiliation":[{"name":"GSK, Hepatology, Stevenage, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R2-20250504","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1016\/S0140-6736(18)30499-9","article-title":"The hepatitis B epidemic in China should receive more attention.","volume":"391","author":"Chen","year":"2018","journal-title":"Lancet"},{"key":"R3-20250504","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/S2468-1253(23)00197-8","article-title":"Global prevalence, cascade of care, and prophylaxis coverage of hepatitis B in 2022: a modelling study.","volume":"8","year":"2023","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"R4-20250504","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.jhep.2007.11.011","article-title":"Natural history of chronic hepatitis B: special emphasis on disease progression and prognostic factors.","volume":"48","author":"Fattovich","year":"2008","journal-title":"J Hepatol"},{"key":"R5-20250504","first-page":"769","article-title":"Guidelines for prevention and treatment of chronic hepatitis B.","volume":"9","author":"Wang","year":"2021","journal-title":"J Clin Transl Hepatol"},{"key":"R6-20250504","doi-asserted-by":"crossref","first-page":"e0201887","DOI":"10.1371\/journal.pone.0201887","article-title":"Factors influencing choice of health system access level in China: a systematic review.","volume":"13","author":"Liu","year":"2018","journal-title":"PLoS One"},{"key":"R7-20250504","doi-asserted-by":"crossref","first-page":"13948","DOI":"10.1038\/s41598-019-50173-5","article-title":"Prevalence of hepatitis B virus infection in Shenzhen, China, 2015-2018.","volume":"9","author":"Tao","year":"2019","journal-title":"Sci Rep"},{"key":"R8-20250504","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1186\/s12889-018-5984-6","article-title":"Epidemiological study of hepatitis B and hepatitis C infections in Northeastern China and the beneficial effect of the vaccination strategy for hepatitis B: a cross-sectional study.","volume":"18","author":"Wang","year":"2018","journal-title":"BMC Public Health"},{"issue":"10 Suppl 3","key":"R9-20250504","doi-asserted-by":"crossref","first-page":"S175","DOI":"10.1097\/00004836-200411003-00010","article-title":"Cost of chronic hepatitis B infection in China.","volume":"38","author":"Zhiqiang","year":"2004","journal-title":"J Clin Gastroenterol"},{"key":"R10-20250504","doi-asserted-by":"crossref","first-page":"e11406","DOI":"10.1097\/MD.0000000000011406","article-title":"Different interventional criteria for chronic hepatitis B pregnant women with HBeAg(+) or HBeAg(-): epidemiological data from Shaanxi, China.","volume":"97","author":"Chen","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"R11-20250504","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1007\/s12072-016-9741-6","article-title":"Cost-effectiveness analysis of tenofovir disoproxil fumarate for treatment of chronic hepatitis B in China.","volume":"10","author":"Ke","year":"2016","journal-title":"Hepatol Int"},{"key":"R12-20250504","doi-asserted-by":"crossref","first-page":"12090","DOI":"10.1038\/s41598-017-12005-2","article-title":"Prevalence of chronic hepatitis B and status of HBV care among rural women who planned to conceive in China.","volume":"7","author":"Wang","year":"2017","journal-title":"Sci Rep"},{"key":"R13-20250504","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3851\/IMP3205","article-title":"Real-world evidence for nucleoside\/nucleotide analogues in a 5-year multicentre study of antiviral-naive chronic hepatitis B patients in China: 52-week results.","volume":"23","author":"Jia","year":"2018","journal-title":"Antivir Ther"},{"key":"R14-20250504","doi-asserted-by":"crossref","first-page":"e193","DOI":"10.1017\/S0950268819000815","article-title":"Real-world study on clinical outcomes of nucleos(t)ide analogues antiviral therapy in patients with chronic hepatitis B.","volume":"147","author":"Sun","year":"2019","journal-title":"Epidemiol Infect"},{"key":"R15-20250504","doi-asserted-by":"crossref","first-page":"e027696","DOI":"10.1136\/bmjopen-2018-027696","article-title":"Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people.","volume":"9","author":"Si","year":"2019","journal-title":"BMJ Open"},{"key":"R16-20250504","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s12916-018-1084-9","article-title":"Chronic hepatitis B virus infection and risk of chronic kidney disease: a population-based prospective cohort study of 0.5 million Chinese adults.","volume":"16","author":"Si","year":"2018","journal-title":"BMC Med"},{"key":"R17-20250504","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.2147\/CLEP.S230589","article-title":"Medication use during pregnancy in mainland China: a cross-sectional analysis of a national health insurance database.","volume":"11","author":"Zhang","year":"2019","journal-title":"Clin Epidemiol"},{"key":"R18-20250504","doi-asserted-by":"crossref","first-page":"647","DOI":"10.2217\/cer-2020-0080","article-title":"Shifting demographics and comorbidity burden in adult Chinese urban patients with chronic hepatitis B, 2013 and 2016.","volume":"10","author":"Hou","year":"2021","journal-title":"J Comp Eff Res"},{"key":"R20-20250504","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1080\/13696998.2017.1297309","article-title":"Understanding the economic burden of heart failure in China: impact on disease management and resource utilization.","volume":"20","author":"Huang","year":"2017","journal-title":"J Med Econ"},{"key":"R21-20250504","doi-asserted-by":"crossref","first-page":"e82","DOI":"10.1016\/j.ijid.2011.10.009","article-title":"Impact of the implementation of a vaccination strategy on hepatitis B virus infections in China over a 20-year period.","volume":"16","author":"Luo","year":"2012","journal-title":"Int J Infect Dis"},{"key":"R22-20250504","doi-asserted-by":"crossref","first-page":"878","DOI":"10.3109\/23744235.2015.1064541","article-title":"A meta-analysis of HBsAg-positive rate among general Chinese populations aged 1\u201359 years.","volume":"47","author":"Zhang","year":"2015","journal-title":"Infect Dis (Lond)"},{"key":"R23-20250504","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S2468-1253(16)30181-9","article-title":"Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study.","volume":"2","author":"Polaris Observatory","year":"2017","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"R24-20250504","doi-asserted-by":"crossref","first-page":"2799","DOI":"10.1097\/CM9.0000000000001842","article-title":"Prevention and control of HIV\/AIDS in China: lessons from the past three decades.","volume":"134","author":"Xu","year":"2021","journal-title":"Chin Med J (Engl)"},{"key":"R25-20250504","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12072-015-9675-4","article-title":"Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update.","volume":"10","author":"Sarin","year":"2016","journal-title":"Hepatol Int"},{"key":"R26-20250504","doi-asserted-by":"crossref","first-page":"e347","DOI":"10.5812\/hepatmon.34790","article-title":"Predictive factors in the incidence of cirrhosis in chronic hepatitis B virus infections.","volume":"16","author":"Alavian","year":"2016","journal-title":"Hepat Mon"},{"key":"R27-20250504","doi-asserted-by":"crossref","first-page":"37498","DOI":"10.1038\/srep37498","article-title":"Female gender lost protective effect against disease progression in elderly patients with chronic hepatitis B.","volume":"6","author":"You","year":"2016","journal-title":"Sci Rep"},{"key":"R28-20250504","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1038\/s41424-018-0007-6","article-title":"Increasing co-morbidities in chronic hepatitis B patients: experience in primary care and referral practices during 2000-2015.","volume":"9","author":"Liu","year":"2018","journal-title":"Clin Transl Gastroenterol"},{"key":"R29-20250504","first-page":"369","article-title":"Eight-year follow-up of the 90,000-person Haimen City cohort: I. Hepatocellular carcinoma mortality, risk factors, and gender differences.","volume":"11","author":"Evans","year":"2002","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"R30-20250504","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1111\/liv.13142","article-title":"Incidence of hepatocellular carcinoma in untreated subjects with chronic hepatitis B: a systematic review and meta-analysis.","volume":"36","author":"Raffetti","year":"2016","journal-title":"Liver Int"},{"key":"R31-20250504","doi-asserted-by":"crossref","first-page":"e0175482","DOI":"10.1371\/journal.pone.0175482","article-title":"No contribution of lifestyle and environmental exposures to gender discrepancy of liver disease severity in chronic hepatitis b infection: observations from the Haimen City cohort.","volume":"12","author":"Sun","year":"2017","journal-title":"PLoS One"},{"key":"R32-20250504","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/S0140-6736(08)60383-9","article-title":"Liver cirrhosis.","volume":"371","author":"Schuppan","year":"2008","journal-title":"Lancet"},{"key":"R33-20250504","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1186\/s40880-015-0015-9","article-title":"Hepatitis B virus reactivation and hepatitis in diffuse large B-cell lymphoma patients with resolved hepatitis B receiving rituximab-containing chemotherapy: risk factors and survival.","volume":"34","author":"Chen","year":"2015","journal-title":"Chin J Cancer"},{"key":"R34-20250504","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1111\/liv.15321","article-title":"Uptake of hepatitis B antiviral treatment: A panel data analysis of 31 provinces in China (2013-2020).","volume":"42","author":"Cheng","year":"2022","journal-title":"Liver Int"},{"key":"R35-20250504","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1038\/s41575-023-00760-9","article-title":"Global burden of hepatitis B virus: current status, missed opportunities and a call for action.","volume":"20","author":"Hsu","year":"2023","journal-title":"Nat Rev Gastroenterol Hepatol"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000036645","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T03:17:21Z","timestamp":1746328641000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000036645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,16]]},"references-count":33,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000036645","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,16]]}}}