Racial and Ethnic Disparities in Characteristics and Care Patterns of Chronic Hepatitis B Patients in the United States. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association Liu, J., Kam, L. Y., Huang, D. Q., Henry, L., Cheung, R., Nguyen, M. H. 2023

Abstract

CHB disproportionately impacts foreign-born patients and those of Asian or Black race. Given the paucity of data, we aimed to study the impact of race/ethnicity on chronic hepatitis B (CHB) patient characteristics and management.A retrospective analysis of adult CHB patients using data recorded in the deidentified Optum Clinformatics® Data Mart Database (1/2003?3/2021) was performed. We characterized and examined the rates of receiving adequate treatment evaluation (measuring HBV DNA and alanine transaminase) and HBV treatment among the racial and ethnic groups.The study cohort included 42,140 patients: age 51.9±15.1 years, 56.1% male, 47% Asian, 26% White, 11% Black, and 7% Hispanic. 33% of White and 48% of Asian patients had annual household income >100,000 USD compared to 16% for Black and 25% for Hispanic patients (P<0.001), with similar disparities in educational levels. About one-third of White (29.3%), Black (35.1%), and Hispanic (35.4%) and half of Asian (49.9%) patients received adequate evaluation (P<0.001). Among patients who met AASLD treatment criteria, treatment rates were similar among White (60.8%, P=0.09) and Black (62.8%, P=0.48) but lower among Hispanic (54.7%, P=0.03) as compared to Asian patients (65.4%). On multivariable logistic regression adjusted for age, sex, provider type, viral co-infection, and fatty liver disease, Hispanic patients were less likely to receive treatment (adjusted hazards ratio: 0.69, 95%CI 0.53?0.91, P=0.01) compared to Asian patients.Compared to Asian CHB patients, non-Asian patients were less likely to undergo adequate evaluation and Hispanic patients less likely to receive treatment for CHB. Additional efforts are needed to improve CHB management, especially for non-Asian patients.

View details for DOI 10.1016/j.cgh.2023.01.035

View details for PubMedID 36781005