241275 Is chronic hepatitis B being undertreated in the U.S.?

Monday, October 31, 2011: 9:10 AM

C. A. Cohen, MPH , Department of Public Health Research, Hepatitis B Foundation, Doylestown, PA
Scott D. Holmberg, MD, MPH , Division of Viral Hepatitis; MS G-37, Centers for Disease Control and Prevention, Atlanta, GA
Brian J. McMahon, MD , Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK
Joan Block, RN, BSN , Hepatitis B Foundation, Doylestown, PA
Carol L. Brosgart, MD , Alios Biopharma, Inc., San Francisco, CA
Robert G. Gish, MD , Division of Gastroenterology and Hepatology, UCSD, San Diego, CA
W.T. London, MD , Department of Public Health Research, Hepatitis B Foundation, Doylestown, PA
T. Block, PhD , College of Medicine, Drexel University, Philadelphia, PA
Chronic infection with the hepatitis B virus (HBV) is a major risk factor for development of end-stage liver disease and primary liver cancer. Despite the fact that there are between 1.4 and 2 million chronic HBV infections in the U.S., fewer than 50,000 people per year receive prescriptions for HBV medications. This presentation discusses possible explanations for this disparity. Data suggest that the largest gap remains in under-diagnosing HBV, with less than 40% of infected individuals aware of their infection. An additional barrier lies in access to care for infected individuals, with only approximately 15% of all infected individuals and less than 40% of diagnosed individuals entering into appropriate medical care for their HBV infection. Explanations for these gaps can include low screening and medical referral rates due to a number of physician and community-related barriers. This includes environmental barriers (lack of access) and individual barriers (low HBV knowledge, fear of stigmatization). Physician barriers include lack of knowledge about HBV and current screening/management guidelines. With only 10-15% of treatment-eligible individuals receiving HBV treatment, we discuss a true health inequity, especially for disproportionately affected populations, including Asian and Pacific Islanders (API). This disparity remains largely unexplored, and points to the need for further research to ensure that all high-risk individuals have equal access to HBV screening and care. Additionally, there is a vital need for effective methods of ensuring that chronically infected individuals receive regular monitoring of their infection and be treated if and when appropriate.

Learning Areas:
Chronic disease management and prevention
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research

Learning Objectives:
1. Participants will be able to describe current barriers to hepatitis B screening, access to care, and treatment in Asian and Pacific Islander communities in the U.S. 2. Participants will be able to discuss potential explanations for inconguencies associated with hepatitis B treatment in the U.S.

Keywords: Asian and Pacific Islander, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved in hepatitis B public health research for over 10 years, focusing on related health disparities.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Gilead Pharmaceuticals hepatitis Stock Ownership
Bristol Myers Squibb hepatitis Stock Ownership

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.