P-50 CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF PATIENTS WITH ACUTE HEPATITIS B VIRUS IN A PUBLICAL HOSPITAL IN CHILE FROM 2015 TO 2022.

Conflict of interest

No

Introduction and Objectives

Since Chile is a low endemic Hepatitis B virus (HBV) country, most cases present as acute infection that resolves spontaneously (95%). There is scarce literature describing the demographic characteristics and serological follow-up of patients with acute HBV infection in Chile.

The objective is to describe demographic, clinical, laboratory and serological characteristics of patients evaluated in the viral hepatitis polyclinic of a Chilean public hospital. To evaluate indication criteria, received treatments, and surrogate markers of therapeutic objectives.

Patients / Materials and Methods

Observational, retrospective study including adults with acute HBV infection, without immunodeficiency, controlled in hepatology policlinic between 2015 and 2022 at Hospital del Salvador. Descriptive statistics were used to determine the demographic characteristics of this population, criteria for indication of antiviral therapy and surrogate markers of therapeutic targets.

Results and Discussion

180 clinical records were reviewed. 147 were excluded: poor treatment adherence and follow-up (30), deceased (59), chronic HBV infection (39) and immunodeficiency (19). 33 patients were included in the analysis, with mean age of 32.3 years and 69.6% being men. Sexual transmission was the most frequent transmission mechanism (48%). There were no cases with cirrhosis at the time of diagnosis. 6 patients (18.1%) required antiviral treatment due to severity, being entecavir the antiviral most frequently prescribed. 36.3% achieved ALT normal levels, most of them at the third month. 39.3% achieved loss of the HBV surface antigen (HBsAg).

Conclusions

Most patients achieved loss of HBsAg, however, many had no follow-up HBsAg studies or did not adhere to medical controls. Only 1 patient was diagnosed as chronic infection during follow-up. Follow-up and adherence to medical controls in patients with acute HBV infection need to be improved.

TREATMENT N: 33 PATIENTS WITH HBV ACUTE INFECTION
Treatment indication criteria	N (%)
HVB chronic hepatitis with persistent ALT >1.1 above normal level and viral load HVB >2.000 UI/mL	1 (3.03)
No treatment indication	27 (81.81)
Severe acute hepatitis with or without liver failure	5 (15.15)
Antiviral prescription n= 6
1. ENTECAVIR	6 (100%)
TREATMENT AND FOLLOW-UP RESULTS
ALT level normalization (< 55 UI/mL)
1. Yes	12 (36,36)
2. Normal baseline level	6 (18,18)
3. No follow-up	13 (39,39)
4. No ALT baseline levels	2 (6,06)
Time to ALT normalization
1. Month 3	7 (21,21)
2. Month 6	2 (6,06)
3. Month 12	1 (3,03)
4. Month 18	2 (6,06)
5. Normal prior to first control	3 (9,09)
6. No follow-up	18 (54,54)
HBsAg loss
1. Yes	13 (39,39)
2. No	1 (3,03)
3. No follow-up	19 (57,57)
Time to HBsAg loss
1. Month 3	6 (18,18)
2. Month 6	5 (15,15)
3. Month 12	1 (3,03)
4. Month 18	1 (3,03)
5. No follow-up	19 (57,57)
6. Persistent positive HBsAg	1 (3,03)

Clinical and serological characteristics of patients with acute HBV infection.