Racial Disparities in Treatment Initiation and Outcomes of Chronic Hepatitis B Virus Infection in North America

作者：Mandana Khalili, Kelsey R. Leonard, Marc G. Ghany, Mohamed A. Hassan, Lewis R. Roberts, Richard K. Sterling, Steven H. Belle, Anna S. Lok, Daryl Lau, Raymond Chung, Adrian M. Di Bisceglie, Mauricio Lisker‐Melman, Harry L.A. Janssen, David Wong, Joshua Juan, Jordan J. Feld, Colina Yim, William M. Lee, Carol S. Murakam, Robert Perrillo, Son Do, Steven‐Huy B. Han, Tram T. Tran, Norah A. Terrault, Stewart Cooper, Robert J. Fontana, Naoky Tsai, Barak Younoszai, Michael Fried, Jama M. Darling, Andrew J. Muir, Donna M. Evon, Robert C. Carithers, Margaret C. Shuhart, Kris V. Kowdley, Chia C. Wang, Velimir A. Luketic, T. Jake Liang, Jay H. Hoofnagle, Edward Doo, Kyong‐Mi Chang, Jang‐June Park, Abdus S. Wahed, Wendy C. King, David E. Kleiner · 发表于：JAMA Network Open · 年份：2023 · DOI：10.1001/jamanetworkopen.2023.7018 · 被引用次数：23 · 研究领域：Hepatitis B Virus Studies、Hepatitis C virus research、Hepatitis Viruses Studies and Epidemiology

Importance: Disparities in treatment initiation may affect outcomes, but data on racially diverse populations with chronic hepatitis B virus (HBV) infection are limited. Objective: To examine whether HBV treatment initiation and outcomes differ among racial groups. Design, Setting, and Participants: From January 14, 2011, to January 28, 2018, hepatitis B surface antigen-positive adults (age ≥18 years) not receiving anti-HBV therapy were enrolled and followed up at weeks 12, 24, and every 24 weeks thereafter in a multicenter longitudinal cohort study (Hepatitis B Research Network [HBRN] adult cohort study) conducted in North America. The last study visit and data collection were completed January 28, 2019. Data were analyzed from August 27, 2021, to August 25, 2022. All HBRN participants were included unless they had acute HBV, HIV, hepatitis C or D, less than 24-weeks of follow-up after enrollment, initiated treatment at or immediately after enrollment, or had unknown race. Exposures: Participants had clinical and laboratory assessments and could receive anti-HBV treatment after enrollment. Main Outcomes and Measures: Hepatitis B virus treatment initiation and major adverse liver outcomes (hepatic decompensation, hepatocellular carcinoma, liver transplant, and death). Results: Of 1550 participants, 193 (12%) were African American or Black, 1157 (75%) were Asian, 157 (10%) were White, and 43 (3%) were other races; 789 (51%) were women, and the median age was 41.2 (IQR, 32.9-51...