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Factors associated with adherence to antiviral therapy in patients with HBV-related cirrhosis

  

  1. 1.Beijing You' an Hospital of Capital Medical University,  Beijing 100069，China; 2.Department of
    Epidemiology and Biostatistics,  Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, 
    School of Basic Medicine Peking Union Medical College,  Beijing 100005； 3.Department of Research
    and Education Administration Beijing Centers for Disease Control and Prevention,  Beijing 100013, China
  • Online:2018-11-05 Published:2018-12-10
  • Contact: Corresponding author: Chen Yu, chybeyond@163.com; Wang Li, liwang@ibms.pumc.edu.cn

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Abstract: Objective  Based on real clinical data,  we firstly evaluated the adherence to antiviral therapy of patients with HBVrelated cirrhosis and explored the factors influencing the adherence of these patients. Methods  Demographic characteristics,  routine biochemical and virological detection data and antiviral prescription information of patients with HBVrelated cirrhosis who were referred to Beijing You'an Hospital during Feb 14,  2008 and Dec 31,  2012 were collected from the hospital's electronic database. According to the patients' antiviral dispensary records,  we used the medication possession rate(MPR)  to evaluate the level of adherence to antiviral treatment of patients with HBVrelated cirrhosis. Multivariate logistic regression was used to analyze the factors affecting the good adherence.Results  A total of 299 patients treated with ADV or ETV in Beijing area, with 117  patients being HBeAg positive and 182 being HBeAg negative. The male patients accounted for 65.9%. MPR was greater than or equal to 80% in most patients,  accounting for 68%; the patients whose MPR  greater than or equal to 95% accounted for 45%; the patients whose MPR was equal to 100% accounted for 26.1% and the patients whose MPR < 50% only accounted for 12%.Multivariate logistic regression was used to explore the factors associated with good adherence. Univariate analysis revealed that the medication adherence showed positive correlation with baseline ALB ≥ 35 g/L（OR=2.27，95%CI=1.4253.618）,  baseline CHE≥4 000  U/L(OR=2.601,  95%CI=1.6174.183);  and negative correlation with the longer treatment time (OR=0.549,  95%CI=0.3890.757). It was showed that only treatment time had significant association with medication adherence (OR=0.021,  95%CI=0.0050.088) through multivariate analysis. Conclusion  Compared to other chronic diseases,  the level of adherence to antiviral therapy of patients with HBVrelated cirrhosis is not lower. Patients with longer time of treatment tend to show  poorer adherence.

Key words: liver cirrhosis, hepatitis B, antiviral agents, medication adherence