Stanford University Medical Center.
Yale University School of Medicine.
Gilead Sciences, Inc.
University of Washington.
Truven Health Analytics.
University College London.
King's College Hospital.
Henry Ford Hospital.
Chronic hepatitis B (CHB) comorbidity data are limited. Using insurance claims databases, our aims were to determine the prevalence and incidence of non-liver comorbidities in CHB patients over time and the predictors of select comorbidities in CHB patients. Patients were adults with continuous coverage (Commercial/Medicare or Medicaid) 6 months prior to and after the first CHB diagnosis and matched non-CHB patients. Deyo-Charlson comorbidity index (DCCI) and comorbidities were analyzed (cardiovascular disease [CVD], carcinoma, diabetes [DM], obesity, hypertension [HTN], hyperlipidemia [HPL], alcohol use, renal impairment [RI], chronic kidney disease and [CKD]osteoporosis/fracture [OF]). Study population included 44,026 CHB cases and 121,568 matched controls. CHB patient mean age increased from 48.1±11.9 in 2006 to 51.8±12.4 years in 2015 for Commercial/Medicare and 44.1±11.1 to 50.2±10.2 years for Medicaid (P<0.001 for both). The Medicaid CHB cohort was the sickest (DCCI=2.6, P<0.001). The Commercial/Medicare 2006 CKD prevalence rate was 36.1/1000 in CHB and 10.2/1000 in controls, increasing to 97.6 and 38.8 in 2015, respectively. The 2006 CKD incidence (per 1,000 person-years) was 10.3 and 4.8; 15.2 and 11.3 by 2015, respectively (P<0.05 for all). Strongest predictors for CKD were: DM (HR: 2.48), HTN (HR: 3.29), and CVD (HR: 2.61) (all P<0.0001). Similar prevalence and incidence changes were observed for OF. Strongest predictors for OF were female (HR: 2.22), alcohol use (HR: 2.02), and viral coinfection (HR: 1.37) (all P<0.0001).
Insured CHB patients were older with more comorbidities and experienced higher incidence and prevalence of CKD and OF than controls.