No racial disparities observed in chronic HBV treatment rates among eligible patients
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Key takeaways:
- Fewer African American or Black participants met chronic HBV treatment criteria compared with other races.
- Treatment rates did not differ by race among patients eligible for treatment.
Although Black individuals with chronic hepatitis B were less likely to meet treatment criteria, researchers reported no significant differences in treatment initiation between racial groups, according to data in JAMA Network Open.
“Because Asians and Blacks have higher prevalence of chronic HBV infection and are more likely to develop liver cancer, we examined whether there are racial disparities in treatment initiation,” Anna Lok, MD, assistant dean for clinical research and director of clinical hepatology at Michigan Medicine, told Healio. “Our results may not be generalized to patients in the general population where there may be racial disparity in access to specialist care.”
Lok and colleagues used data from the Hepatitis B Research Network adult cohort study, which recruited a racially diverse group of individuals with chronic HBV from centers in the U.S. and Canada, to investigate whether treatment initiation and outcomes differed by racial group.
Analysis included 1,550 HBV surface antigen-positive adults (median age, 41.2 years; 51% women) not receiving antiviral therapy who were enrolled from 2011 to 2018 and had visits at weeks 12 and 24 and every 24 weeks thereafter. Most participants identified as Asian (75%), followed by African American or Black (12%), white (10%) and other races (3%). Of the African American or Black participants, 20% were born in the U.S., 47% in East Africa, 27% in West Africa and 6% elsewhere.
During 5,727 person-years of follow-up, 504 participants began anti-HBV treatment at a rate of 4.8 per 100 person-years in African American or Black participants, 6.6 per 100 person-years in white participants, 7.9 per 100 person-years in those of other races and 9.9 per 100 person-years in Asian participants. Researchers noted “significant differences” in treatment initiation among African American or Black participants, depending on place of birth.
Researchers also reported a lower proportion of African American or Black participants (14%) met treatment criteria compared with Asian (22%) and white (27%) individuals, although the cumulative probabilities of treatment initiation after meeting criteria were “not significantly different” among groups (African American or Black = 0.45; Asian = 0.38; white = 0.4 at 48 weeks, and African American or Black = 0.45; Asian = 0.51; white = 0.51 at week 72).
“In this large multiracial [chronic hepatitis B] cohort in North America, race and socioeconomic factors were not associated with treatment initiation,” Lok and colleagues wrote. “We observed a treatment gap between participants eligible for and those receiving treatment, suggesting that efforts to increase awareness of HBV and training of health care professionals, along with simplifying treatment guidelines, will be necessary to achieve the World Health Organization’s goals of HBV elimination by 2030.”
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