Research Focus

Inside Stanford Digestive Health - Summer/Fall 2024

Hepatitis B Is Globally Underassessed and Undertreated, Especially Among Women and Asian Minorities in the West.

Targeted outreach to eliminate the disease by 2030 is required

Chronic HBV affects approximately 300 million people globally, leading cirrhosis, liver failure, liver cancer, and 555,000 deaths in 2019.  In clinical practice, we continue to see patients with advanced liver disease due to HBV despite having vaccines for prevention for several decades and, since 2005, effective and safe oral therapy for those who meet guideline criteria for treatment.

In this study, we examined the evaluation and treatment rates of patients from the REAL-B consortium, a global collaboration of experts from 25 study centers across nine countries who treat patients with HBV.

Key findings uncovered by the study are:

·      Among 12,566 patients with chronic HBV infection, only about three-quarter received adequate evaluation.

·      Among adequately evaluated patients, about one-third met criteria for treatment by professional society guidelines.

·      Among those who met treatment criteria, about 80-85% received treatment.

·      Significant sex disparities: Females were more likely to undergo adequate evaluation, but were 50% less likely to initiate treatment when indicated.

·      Ethnic disparities: Asian patients from the West were about 40-50% less likely to undergo adequate evaluation or to initiate antiviral treatments when indicated, as compared to Asian patients from the East, possibly due to language and cultural barriers, in addition to other socioeconomic factors.

Caption: Data from the REAL-B consortium reveal a global underassessment and undertreatment of chronic hepatitis B (HBV), especially among women and Asian minorities in the West (Credit: Journal of Hepatology).

The World Health Organization's goal is to eliminate viral hepatitis by 2030. As such, targeted outreach is needed to reduce new infections and deaths. This new research provides clinicians and policymakers with strong data to further improve current guidance on meeting this goal as well as helping to improve patient outcomes.

Read more-

Sex and ethnic disparities in hepatitis B evaluation and treatment across the world.

Kudaravalli S, Huang DQ, Yeh ML, Trinh L, Tsai PC, Hsu YC, Kam LY, Nguyen VH, Ogawa E, Lee DH, Ito T, Watanabe T, Enomoto M, Preda CM, Ko MKL, Wan-Hin Hui R, Atsukawa M, Suzuki T, Marciano S, Barreira A, Do S, Uojima H, Takahashi H, Quek SXZ, Toe Wai Khine HH, Ishigami M, Itokawa N, Go MS, Kozuka R, Marin RI, Sandra I, Li J, Zhang JQ, Wong C, Yoshimaru Y, Vo DKH, Tseng CH, Lee CJ, Inoue K, Maeda M, Hoang JK, Chau A, Chuang WL, Dai CY, Huang JF, Huang CF, Buti M, Tanaka Y, Gadano AC, Yuen MF, Cheung R, Lim SG, Trinh HN, Toyoda H, Yu ML, Nguyen MH.

J Hepatol. 2024 Jul;81(1):33-41. doi: 10.1016/j.jhep.2024.02.033. Epub 2024 May 1.

PMID: 38906621

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