Evidence-Based Medicine
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jun 28, 2016; 8(18): 762-769
Published online Jun 28, 2016. doi: 10.4254/wjh.v8.i18.762
Treating chronic hepatitis B virus: Chinese physicians’ awareness of the 2010 guidelines
Lai Wei, Ji-Dong Jia, Xin-Hua Weng, Xiao-Guang Dou, Jia-Ji Jiang, Hong Tang, Qin Ning, Qing-Qing Dai, Run-Qin Li, Jie Liu
Lai Wei, Department of Hepatology, Peking University People’s Hospital, Beijing 100044, China
Ji-Dong Jia, Department of Hepatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100029, China
Xin-Hua Weng, Department of Infectious Disease, Shanghai Huashan Hospital, Shanghai 200040, China
Xiao-Guang Dou, Department of Infectious Disease, Shengjing Hospital of China Medical University, Shenyang 110022, Liaoning Province, China
Jia-Ji Jiang, Department of Hepatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
Hong Tang, Department of Infectious Disease, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Qin Ning, Department of Infectious Disease, Affiliated Tongji Hospital of Tongji Medical College, Wuhan 430030, Hubei Province, China
Qing-Qing Dai, SmithStreet, Shanghai 200040, China
Run-Qin Li, Jie Liu, Bristol-Myers Squibb, Shanghai 200240, China
Author contributions: Wei L, Jia JD, Weng XH, Dou XG, Jiang JJ, Tang H and Ning Q (ranking reference their input) analyzed the data, interpreted data in final review, and final approval of the manuscript; Dai QQ designed the survey, completed data acquisition, analysis and interpretation, and final approval of the manuscript; Li RQ and Liu J designed the survey, analyzed and interpreted data, drafted the paper and revised it critically for important intellectual content and final approval of the manuscript.
Supported by Bristol-Myers Squibb.
Conflict-of-interest statement: Lai Wei has received research support and/or consulting fees from BristolMyers Squibb, Roche and Novartis. Ji-Dong Jia has received research support, consulting fees and speaker fees from Bristol-Myers Squibb, consulting fees and speaker fees from Gilead, and research support from Novartis. Xin-Hua Weng has received consulting fees and speaker fees from Novartis, Roche and Bristol-Myers Squibb, and speaker fees from Pfizer and AstraZeneca. Xiao-Guang Dou and Jia-Ji Jiang have no conflicts of interest to declare. Hong Tang has received research support, consulting fees and speaker fees from Bristol-Myers Squibb, Novartis and Roche. Qin Ning has received research support and consulting fees from Novartis, Bristol-Myers Squibb and Roche, and consulting fees from GlaxoSmithKline. Qing-Qing Dai is an employee of SmithStreet. Run-Qin Li and Jie Liu are employees of Bristol-Myers Squibb.
Data sharing statement: The survey participants gave consent for information to be shared. The data was collected by on-line survey or off-line survey (post or fax). No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lai Wei, MD, PhD, Department of Hepatology, Peking University People’s Hospital, 11 Xizhimen South Street, Xicheng District, Beijing 100044, China. weilai@pkuph.edu.cn
Telephone: +86-10-88325566 Fax: +86-10-66515490
Received: December 9, 2015
Peer-review started: December 10, 2015
First decision: January 18, 2016
Revised: March 17, 2016
Accepted: April 5, 2016
Article in press: April 6, 2016
Published online: June 28, 2016
Abstract

AIM: To investigate Chinese physicians’ awareness of the 2010 guidelines on the treatment of chronic hepatitis B virus (HBV) infection.

METHODS: This was a quantitative survey that investigated the characteristics and practices of physicians who were treating patients with hepatitis B, the profile of their patients and physician practices regarding the diagnosis and treatment of HBV at the time of the survey. Participants were randomly selected from available databases of Chinese physicians and requested to complete either an online or paper-based survey. Data from the survey responses were analysed. For data validation and interpretation, qualitative indepth interviews were conducted with 39 of the respondents.

RESULTS: Five-hundred completed surveys, from 663 physicians were available for analysis. A mean of 175 chronic hepatitis B (CHB) patients was seen by each physician every month, of whom 85 (49%) were treated in line with therapeutic indications stated in the 2010 guidelines. A total of 444 (89%) physicians often (> 60% of the time) adhered to the guidelines. Most physicians used antiviral medications as recommended. For patients with compensated and decompensated cirrhosis, 342 (68%) and 336 (67%) of physicians, respectively, often followed the recommendation to use potent nucleos(t)ide analogues with a high genetic barrier to resistance, using the appropriate treatment more than 60% of the time. Physicians from infectious disease or liver disease departments were better informed than those from gastrointestinal or other departments.

CONCLUSION: The majority of Chinese physicians often adhere to Chinese 2010 CHB guidelines and are well-informed about the use of antiviral medications for hepatitis B.

Keywords: Chronic hepatitis B, Practice guidelines, Awareness, China, Physicians

Core tip: In general, the majority of Chinese physicians often adhere to Chinese 2010 chronic hepatitis B guidelines and they are well-informed about the use of antiviral medications for hepatitis B. Most of the physicians who participated in our survey used antiviral medications as recommended. For patients with compensated and decompensated cirrhosis, more than two-thirds of physicians, often followed the recommendation to use potent nucleos(t)ide analogues with a high genetic barrier to resistance. Our survey also showed that physicians from infectious disease or liver disease departments were better informed than those from gastrointestinal or other departments.