Adherence to antiviral treatment among people living with chronic hepatitis B: A global survey

BACKGROUND Current antiviral treatment for chronic hepatitis B can suppress viral replication and reduce the risk of cirrhosis and liver cancer. It requires lifelong daily medication, and long-term adherence is often cited as a concern when initiating treatment. Hepatitis B treatment adherence in the context of the patient’s medical and life experiences remains underexplored. AIM To evaluate factors associated with adherence to hepatitis B oral antiviral treatment. METHODS A global online survey was administered anonymously to adults (aged 18 years or older) living with chronic hepatitis B. A subsample of 614 individuals who reported being on hepatitis B treatment was included in the analysis. Indices for treatment affordability, healthcare service acceptability, and individual physical, psychological, and emotional functioning were constructed (Cronbach’s alpha = 0.71-0.83). Data analysis was conducted using Stata/BE 17.0. RESULTS Overall, 81% of respondents reported high adherence to hepatitis B treatment. Lower adherence was observed among individuals who identified as African or African American (P = 0.008). Among participants with low adherence, 60% cited affordability as a challenge (P = 0.068), 53% identified healthcare service acceptability as a challenge (P = 0.04), 79% described physical functioning as a challenge (P = 0.002), and 40.5% reported difficulties with psychological functioning (P = 0.55). CONCLUSION Findings demonstrate high treatment adherence, although access to and acceptability of healthcare services, as well as an individual’s physical functioning challenges, appear to be related to low adherence.