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Self-motivated medical care-seeking behaviors and disease progression in a community-based cohort of chronic hepatitis B virus-infected patients in China
BACKGROUND: To determine the treatment behaviors among a community-based cohort of chronic hepatitis B virus (HBV)-infected persons and to examine the disease progression among non-antiviral-treated HBV-infected cases after 5 years of follow-up. METHODS: We conducted a community-based prospective st...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615194/ https://www.ncbi.nlm.nih.gov/pubmed/31286924 http://dx.doi.org/10.1186/s12889-019-7061-1 |
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author | Zheng, Hui Zhang, Guomin Wang, Fuzhen Yin, Zundong Miao, Ning Sun, Xiaojin Liang, Xiaofeng Cui, Fuqiang |
author_facet | Zheng, Hui Zhang, Guomin Wang, Fuzhen Yin, Zundong Miao, Ning Sun, Xiaojin Liang, Xiaofeng Cui, Fuqiang |
author_sort | Zheng, Hui |
collection | PubMed |
description | BACKGROUND: To determine the treatment behaviors among a community-based cohort of chronic hepatitis B virus (HBV)-infected persons and to examine the disease progression among non-antiviral-treated HBV-infected cases after 5 years of follow-up. METHODS: We conducted a community-based prospective study on people with chronic HBV infection in mainland China from 2009 to 2014. In 2009, we recruited participants who were identified as HBV infected in 2006 in a national sero-survey. A face-to-face follow-up investigation was completed in 2014, and the personal information, the clinical diagnosis provided at the last hospital visit, the HBV antiviral treatment history, and the insurance type was collected for each patient for analysis. Multivariable logistic regression was used to identify factors that are associated with active medical care- seeking and antiviral treatments. RESULTS: Among the 2422 chronic HBV-infected patients recruited in 2009, 1784 (73.7%) were followed-up to 2014, and 638 (35.8%) had sought medical care in hospitals; among them, 140 (21.9%) received antiviral treatments. The lowest medical care-seeking rate (26%) was in participants over 50-year old. We determined that the frequency of medical care-seeking was higher among those participants living in urban areas (aRR = 1.3, 95% CI:1.0–1.6), those in 0–19-year old (aRR = 1.5, 95% CI:1.1–2.1), 20–39-year old (aRR = 2.2, 95% CI:1.7–3.0) and 40–49-year old (aRR = 1.5, 95% CI:1.1–2.0), and persons with insurance of the type Urban residents’ basic medical insurance (URBMI) or Commercial health insurance (CHI) (aRR = 2.5, 95% CI:1.7–3.6) and New Rural Cooperative Medical System (NRCMS) (aRR = 1.9, 95% CI:1.4–2.6). Patients were more likely to receive antiviral treatment if they were 20–39-year old (aRR = 0.4, 95% CI:0.3–0.7), had insurance of the type URBMI or CHI (aRR = 2.6, 95% CI:1.1–6.3) or NRCMS (aRR = 3.0, 95% CI:1.3–6.9) and were treated at prefecture and above-level hospitals (aRR = 2.0, 95% CI:1.4–3.0). Among non-antiviral-treated HBV-infected cases, we found the annual rates for HBsAg sero-clearance, progress to cirrhosis and HCC were 1.0, 0.6 and 0.2%, respectively. CONCLUSION: The rates of medical care-seeking and antiviral treatment were low among community-based chronic HBV-infected persons, thus we recommend improving the insurance policies for HBV-infected persons to increase the antiviral treatment rate, and conducting extensive education to promote HBV-infected patients actively seeking medical care from hospitals. |
format | Online Article Text |
id | pubmed-6615194 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66151942019-07-18 Self-motivated medical care-seeking behaviors and disease progression in a community-based cohort of chronic hepatitis B virus-infected patients in China Zheng, Hui Zhang, Guomin Wang, Fuzhen Yin, Zundong Miao, Ning Sun, Xiaojin Liang, Xiaofeng Cui, Fuqiang BMC Public Health Research Article BACKGROUND: To determine the treatment behaviors among a community-based cohort of chronic hepatitis B virus (HBV)-infected persons and to examine the disease progression among non-antiviral-treated HBV-infected cases after 5 years of follow-up. METHODS: We conducted a community-based prospective study on people with chronic HBV infection in mainland China from 2009 to 2014. In 2009, we recruited participants who were identified as HBV infected in 2006 in a national sero-survey. A face-to-face follow-up investigation was completed in 2014, and the personal information, the clinical diagnosis provided at the last hospital visit, the HBV antiviral treatment history, and the insurance type was collected for each patient for analysis. Multivariable logistic regression was used to identify factors that are associated with active medical care- seeking and antiviral treatments. RESULTS: Among the 2422 chronic HBV-infected patients recruited in 2009, 1784 (73.7%) were followed-up to 2014, and 638 (35.8%) had sought medical care in hospitals; among them, 140 (21.9%) received antiviral treatments. The lowest medical care-seeking rate (26%) was in participants over 50-year old. We determined that the frequency of medical care-seeking was higher among those participants living in urban areas (aRR = 1.3, 95% CI:1.0–1.6), those in 0–19-year old (aRR = 1.5, 95% CI:1.1–2.1), 20–39-year old (aRR = 2.2, 95% CI:1.7–3.0) and 40–49-year old (aRR = 1.5, 95% CI:1.1–2.0), and persons with insurance of the type Urban residents’ basic medical insurance (URBMI) or Commercial health insurance (CHI) (aRR = 2.5, 95% CI:1.7–3.6) and New Rural Cooperative Medical System (NRCMS) (aRR = 1.9, 95% CI:1.4–2.6). Patients were more likely to receive antiviral treatment if they were 20–39-year old (aRR = 0.4, 95% CI:0.3–0.7), had insurance of the type URBMI or CHI (aRR = 2.6, 95% CI:1.1–6.3) or NRCMS (aRR = 3.0, 95% CI:1.3–6.9) and were treated at prefecture and above-level hospitals (aRR = 2.0, 95% CI:1.4–3.0). Among non-antiviral-treated HBV-infected cases, we found the annual rates for HBsAg sero-clearance, progress to cirrhosis and HCC were 1.0, 0.6 and 0.2%, respectively. CONCLUSION: The rates of medical care-seeking and antiviral treatment were low among community-based chronic HBV-infected persons, thus we recommend improving the insurance policies for HBV-infected persons to increase the antiviral treatment rate, and conducting extensive education to promote HBV-infected patients actively seeking medical care from hospitals. BioMed Central 2019-07-08 /pmc/articles/PMC6615194/ /pubmed/31286924 http://dx.doi.org/10.1186/s12889-019-7061-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Zheng, Hui Zhang, Guomin Wang, Fuzhen Yin, Zundong Miao, Ning Sun, Xiaojin Liang, Xiaofeng Cui, Fuqiang Self-motivated medical care-seeking behaviors and disease progression in a community-based cohort of chronic hepatitis B virus-infected patients in China |
title | Self-motivated medical care-seeking behaviors and disease progression in a community-based cohort of chronic hepatitis B virus-infected patients in China |
title_full | Self-motivated medical care-seeking behaviors and disease progression in a community-based cohort of chronic hepatitis B virus-infected patients in China |
title_fullStr | Self-motivated medical care-seeking behaviors and disease progression in a community-based cohort of chronic hepatitis B virus-infected patients in China |
title_full_unstemmed | Self-motivated medical care-seeking behaviors and disease progression in a community-based cohort of chronic hepatitis B virus-infected patients in China |
title_short | Self-motivated medical care-seeking behaviors and disease progression in a community-based cohort of chronic hepatitis B virus-infected patients in China |
title_sort | self-motivated medical care-seeking behaviors and disease progression in a community-based cohort of chronic hepatitis b virus-infected patients in china |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615194/ https://www.ncbi.nlm.nih.gov/pubmed/31286924 http://dx.doi.org/10.1186/s12889-019-7061-1 |
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