Black, white and Latino people with chronic hepatitis B are less likely than Asians to be adequately evaluated, and Latinos are less likely to receive treatment, according to study findings published in Clinical Gastroenterology & Hepatology.

The Centers for Disease Control and Prevention estimates that up to 2.4 million people in the United States are living with hepatitis B. Chronic hepatitis B virus (HBV) infection is more common among people who were born outside the United States or have foreign-born parents. Asians and Pacific Islanders have a higher rate of hepatitis B than other racial and ethnic groups. Over time, chronic HBV infection can lead to serious complications, including cirrhosis, liver cancer and end-stage liver disease, so timely evaluation and treatment are important.

Mindie Nguyen, MD, of Stanford University Medical Center, and colleagues explored racial and ethnic disparities in the characteristics of people with chronic hepatitis B and their likelihood of receiving adequate evaluation and treatment.

For this retrospective analysis, the researchers used deidentified data from the Optum Clinformatics Data Mart Database from January 2003 to March 2021. The study population consisted of 42,140 adults with chronic hepatitis B. Just over half (56%) were men, and the average age was 52 years. Nearly half (47%) were Asian, 26% were white, 11% were Black and 7% were Latino.

Looking at patient characteristics, 48% of Asian, 33% of white, 25% of Latino and 16% of Black people with hepatitis B had an annual household income greater than $100,000. Education levels showed similar disparities.

Overall, 41% of the study population was adequately evaluated for hepatitis B, but this varied by race and ethnicity. While 50% of Asians received adequate evaluation, this fell to 35% for Latino and Black people and 29% for white people.

Fewer than two-thirds of patients who met the hepatitis B treatment criteria outlined by the American Association for the Study of Liver Diseases received treatment according to the guidelines. Treatment rates were highest for Asian individuals (65%), comparable for Black and white people (63% and 61%, respectively), and lowest for Latino people (55%).

After adjusting for age, sex, any viral coinfection, fatty liver disease and type of health care provider, Latino people were about two thirds less likely than Asian people to receive hepatitis B treatment.

“Compared to Asian chronic hepatitis B patients, non-Asian patients were less likely to undergo adequate evaluation and Hispanic patients [were] less likely to receive treatment for chronic hepatitis B,” wrote the researchers. “Additional efforts are needed to improve chronic hepatitis B management, especially for non-Asian patients.”

Click here to read the study abstract in Clinical Gastroenterology & Hepatology.

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