| アブストラクト | BACKGROUND: Hepatitis B virus (HBV) infection poses a persistent public health challenge globally, with chronic cases often leading to severe liver diseases and associated comorbidities. In Japan, where the prevalence of chronic HBV remains substantial in the elderly population, the burden of comorbidities and polypharmacy in patients receiving nucleos(t)ide analogue (NUC) therapy is not well characterized. The aim of the present study was to evaluate the prevalence of chronic comorbidities and concomitant medication use in chronic hepatitis B (HBV) patients on NUC therapy in Japan. METHODS: A retrospective, cross-sectional, observational study using a nationwide hospital claims database was conducted. Data were obtained from the Medical Data Vision (MDV) database, comprising 480 hospitals in Japan from 2008 to 2023. Patients with chronic HBV were defined by ICD-10 code plus NUC prescription for HBV; controls had no HBV-related diagnoses or NUC prescriptions. Controls were first selected 1:3 by same age, sex, and visit month, and then propensity score-matched to cases on age, sex, and hospital bed size (caliper 0.2). RESULTS: A total of 25,199 chronic HBV patients on NUC therapy were compared with 134,597 age- and sex-matched non-HBV patients using propensity score matching. Mean ages were 63.7 (SD 12.9) years and 64.3 (SD 15.8) years, respectively; 59.2% and 54.0%, respectively, were male. Patients with chronic HBV had a significantly higher prevalence of comorbidities than non-HBV patients, including cancer (37% vs. 5.5%; difference 31.5% points, 95% confidence interval (CI) 30.8-32.2% points), hypertension (35.5% vs. 8.1%; difference 27.4% points, 95% CI 26.7-28.1% points), and diabetes mellitus (35.2% vs. 5.3%; difference 29.9% points, 95% CI 29.2-30.6% points). In patients aged 70 years or older, 64.8% had two or more chronic comorbidities, and 57.9% were prescribed more than one concomitant medication. The most common concomitant medications included drugs for acid-related disorders (28.1% vs. 0.2%; difference 27.9% points, 95% CI 27.3-28.5% points), agents acting on the renin-angiotensin system (11.8% vs. 0.0%; difference 11.8% points, 95% CI 11.4-12.2% points), and lipid-regulating agents (11.7% vs. 0.1%; difference 11.6% points, 95% CI 11.2-12.0% points). CONCLUSIONS: Chronic HBV patients on NUC therapy in Japan have a substantial burden of comorbidities and polypharmacy, particularly among elderly patients. These findings suggest the need for careful age-specific management to reduce the potential impacts of comorbidities and polypharmacy in chronic HBV patients in Japan. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-026-12517-1. |
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| 投稿者 | Nakamoto, Daisuke; Ohata, Emi; Yuda, Mayumi; Fukui, Nobuyuki; Makino, Nao; Kanamori, Rie; Aoki, Nozomi; Kanazawa, Akio; Mori, Hirotake; Nishizaki, Yuji; Yokokawa, Hirohide; Yano, Yuichiro; Naito, Toshio |
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| 組織名 | Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo,;Japan. d.nakamoto.ll@juntendo.ac.jp.;Center for Promotion of Data Science, Juntendo University Graduate School of;Medicine, Tokyo, Japan.;Japan.;Division of Medical Education, Juntendo University Faculty of Medicine, Tokyo, |
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