April 13, 2020
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More than 80% of people with chronic HBV in US are undiagnosed

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In the United States, more than 80% of privately insured people with chronic hepatitis B infection remain undiagnosed, according to a recent study.

“As of 2015, WHO estimated that despite an effective vaccine that provides 98% to 100% protection against the hepatitis B virus (HBV), an estimated 292 million people were still living with chronic hepatitis B infection (CHB) worldwide. Left untreated, CHB can progress to cirrhosis and hepatocellular carcinoma,” Eiichi Ogawa, MD, PhD, of the division of gastroenterology and hepatology at Stanford University Medical Center, and colleagues wrote. “However, the number of people aware of having CHB is strikingly low. In 2016, the WHO suggested that only 10.5% (27 million) of those with CHB were aware of their illness; and of those, only 16.5% (4.5 million) were receiving treatment.”

To provide an accurate accounting of the number of patients with CHB aged 6 years or older in the U.S. who have not yet been diagnosed, Ogawa and colleagues performed a cross-sectional study using the commercial U.S. Truven Health Market Scan Database to identify patients with CHB diagnosis and the National Health and Nutrition Examination Survey to estimate the actual number of privately insured persons with CHB.

According to the study, the researchers calculated the total population with CHB and the proportion of those who remained undiagnosed among 198,073,302 privately insured individuals and identified diagnosed CHB patients who received one or more prescription for CHB medications to calculate the treatment rate for those with severe disease.

Results showed that only 18.6% (95% CI, 13.5%-29.92%) of the 511,029 (95% CI, 317,733-704,325) individuals with CHB had been diagnosed, meaning that 81.4% (95% CI, 70.08%-86.5%) were undiagnosed. Additionally, treatment rates were 34.79% (95% CI, 33.31%-36.27%) for those with cirrhosis and 48.64% (95% CI, 45.59%-51.69%) for those with hepatocellular carcinoma.

“This study found low rates of hepatitis B diagnosis among privately insured individuals, suggesting that barriers to diagnosis may be both financial and nonfinancial,” the authors concluded. “Additional research is needed to characterize these barriers and to develop interventions to improve diagnosis rates.” – by Caitlyn Stulpin

Disclosures: Ogawa reports no relevant financial disclosures. Please see the study for all other author’s relevant financial disclosures.