Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Zheng, Hui, Zhang, Guomin, Wang, Fuzhen, Yin, Zundong, Miao, Ning, Sun, Xiaojin, Liang, Xiaofeng, Cui, Fuqiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
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
_version_ 1783433318520324096
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
work_keys_str_mv AT zhenghui selfmotivatedmedicalcareseekingbehaviorsanddiseaseprogressioninacommunitybasedcohortofchronichepatitisbvirusinfectedpatientsinchina
AT zhangguomin selfmotivatedmedicalcareseekingbehaviorsanddiseaseprogressioninacommunitybasedcohortofchronichepatitisbvirusinfectedpatientsinchina
AT wangfuzhen selfmotivatedmedicalcareseekingbehaviorsanddiseaseprogressioninacommunitybasedcohortofchronichepatitisbvirusinfectedpatientsinchina
AT yinzundong selfmotivatedmedicalcareseekingbehaviorsanddiseaseprogressioninacommunitybasedcohortofchronichepatitisbvirusinfectedpatientsinchina
AT miaoning selfmotivatedmedicalcareseekingbehaviorsanddiseaseprogressioninacommunitybasedcohortofchronichepatitisbvirusinfectedpatientsinchina
AT sunxiaojin selfmotivatedmedicalcareseekingbehaviorsanddiseaseprogressioninacommunitybasedcohortofchronichepatitisbvirusinfectedpatientsinchina
AT liangxiaofeng selfmotivatedmedicalcareseekingbehaviorsanddiseaseprogressioninacommunitybasedcohortofchronichepatitisbvirusinfectedpatientsinchina
AT cuifuqiang selfmotivatedmedicalcareseekingbehaviorsanddiseaseprogressioninacommunitybasedcohortofchronichepatitisbvirusinfectedpatientsinchina