Estimating the Proportion and Characteristics of Diagnosed Chronic Hepatitis B: A retrospective nationwide longitudinal study, Korea

Abstract

Background: The World Health Organization aims for 90% of chronic hepatitis B (CHB) patients to be diagnosed, and 80% or more of CHB patients to be treated in order to eliminate CHB until 2030. However, the proportion of ‘In cared’ CHB patients is still largely unknown in many countries. We aimed to estimate the proportion and characteristics of ‘In cared’ CHB patients in Korea. Method: This study used insurance reimbursement claims data provided by National Health Insurance Service (NHIS). A total of 553,085 eligible patients were defined as ‘In cared’ CHB patients, and the proportion and characteristics of diagnosed CHB patients were evaluated according to age, sex, region, and income level. Results: The estimated ‘In cared’ rate of CHB patients was 38.1%; the rate was highest in patients in their 40s (44.8%) and lowest in those in their 20s (29.4%). The ‘In cared’ rate of men was lower than women (36.7% vs. 40.5%), but the ‘In cared’ rate was similar per region (metropolitan area vs. other regions) and social economic status (high vs. low income). The proportion of diabetes, hypertension, dyslipidemia, coronary heart disease, and chronic kidney disease in ‘In cared’ CHB was 32.6%, 30.1%, 43.5%, 14.0%, and 3.0%, respectively. The 15-year survival rate was 93.8% in ‘In cared’ CHB patients in Korea (92.5% in men and 95.5% in women). The cumulative incidence of hepatocellular carcinoma (HCC) was 18.2% in ‘In cared’ CHB patients in Korea (20.7% in men and 14.4% in women) over a 15-year period. However, there was no significant difference in the incidence of HCC and mortality according to region and social economic status. Conclusion: The ‘In cared’ rate among patients with CHB was 38.1%, and the ‘In cared’ rate of men was lower than that of women (36.7% vs. 40.5%).