Objective: Hepatitis B virus (HBV) infection is a highly endemic disease in China. The guidelines of the European Association for the Study of the Liver and the Asian Pacific Association for the Study of the Liver have improved in recent years. Here, we present a survey of physicians in terms of trends in the management of HBV at a teaching hospital in Southwest China.
Methods: A questionnaire adopted from an earlier Spanish study was used. Physicians in an affiliated hospital of a Chinese medical university were surveyed.
Results: A total of 120 (100%) physicians (including 68 fellows) answered the questionnaire voluntarily. Eighty percent (96/120) reported experience in the treatment of hepatopathy. Although a huge majority (90.9%, 109/120) were aware of the Chinese consensus recommendations on HBV, only 51.8% (62/120) correctly identified the indications for the treatment of chronic hepatitis B and 42.5% (51/120) correctly described the end-points in treating HBeAg-positive or HBeAg-negative chronic hepatitis. Serum HBV-DNA levels were used to monitor therapy by 84.2% (101/120) of the respondents, the HBV drug resistance test was used by 77.5% (93/120) of the responders, and antiviral prophylaxis was recommended by 65% (78/120) for HBV carriers who would receive immunosuppressive therapy. About 27.5% (33/120) recommended interferon or pegylated interferon as the initial treatment for HBeAg-positive patients; 93.3% (112/120) recommended oral antiviral therapy to HBeAg-negative patients. Physicians working at teaching hospitals were significantly more likely to recommend antiviral prophylaxis for HBV patients who receive immunosuppressive therapy than physicians working at nonuniversity hospitals (83 vs. 51%; P<0.001).
Conclusion: The inadequate management of chronic hepatitis B by Chinese physicians calls for an improvement in education, especially for physicians in county hospitals or clinics.