{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:18:08Z","timestamp":1791598688081,"version":"4.3.4"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Disparities in treatment initiation may affect outcomes, but data on racially diverse populations with chronic hepatitis B virus (HBV) infection are limited.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine whether HBV treatment initiation and outcomes differ among racial groups.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>From January 14, 2011, to January 28, 2018, hepatitis B surface antigen\u2014positive adults (age \u226518 years) not receiving anti-HBV therapy were enrolled and followed up at weeks 12, 24, and every 24 weeks thereafter in a multicenter longitudinal cohort study (Hepatitis B Research Network [HBRN] adult cohort study) conducted in North America. The last study visit and data collection were completed January 28, 2019. Data were analyzed from August 27, 2021, to August 25, 2022. All HBRN participants were included unless they had acute HBV, HIV, hepatitis C or D, less than 24-weeks of follow-up after enrollment, initiated treatment at or immediately after enrollment, or had unknown race.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Participants had clinical and laboratory assessments and could receive anti-HBV treatment after enrollment.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Hepatitis B virus treatment initiation and major adverse liver outcomes (hepatic decompensation, hepatocellular carcinoma, liver transplant, and death).<\/jats:p><\/jats:sec>Results<\/jats:title>Of 1550 participants, 193 (12%) were African American or Black, 1157 (75%) were Asian, 157 (10%) were White, and 43 (3%) were other races; 789 (51%) were women, and the median age was 41.2 (IQR, 32.9-51.6) years. Sociodemographic and virologic parameters differed between groups. During 5727 person-years of follow-up, 504 participants initiated treatment, with incidences of 4.8 per 100 person-years in African American or Black individuals, 9.9 per 100 person-years in Asian individuals, 6.6 per 100 person-years in White individuals, and 7.9 per 100 person-years in those of other races (P<\/jats:italic>\u2009&amp;lt;\u2009.001). A lower proportion (14%) of African American or Black participants met treatment criteria compared with Asian (22%) and White (27%) individuals (P<\/jats:italic>\u2009=\u2009.01). The cumulative probabilities of treatment initiation after meeting the criteria were not significantly different among racial groups (African American or Black, 0.45; Asian, 0.38; White, 0.40 at 48 weeks and African American or Black, 0.45; Asian, 0.51; White, 0.51 at 72 weeks; P<\/jats:italic>\u2009=\u2009.68). The incidence of major adverse liver outcomes was 0.1 per 100 person-years and did not differ by race.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this observational study of chronic HBV, African American or Black participants were less likely than individuals of other races to meet treatment criteria, but among those who did, HBV treatment receipt did not differ significantly by race or socioeconomic factors. Not all eligible participants initiated treatment, but adverse liver outcomes were rare. These findings may not be generalizable to patients with chronic HBV receiving care in other settings.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.7018","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T15:01:24Z","timestamp":1681138884000},"page":"e237018","source":"Crossref","is-referenced-by-count":24,"title":["Racial Disparities in Treatment Initiation and Outcomes of Chronic Hepatitis B Virus Infection in North America"],"prefix":"10.1001","volume":"6","author":[{"given":"Mandana","family":"Khalili","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey R.","family":"Leonard","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc G.","family":"Ghany","sequence":"additional","affiliation":[{"name":"Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Hassan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis R.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard K.","family":"Sterling","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven H.","family":"Belle","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania"},{"name":"Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna S.","family":"Lok","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Hepatitis B Research Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daryl T-Y","family":"Lau","sequence":"additional","affiliation":[{"name":"and the Hepatitis B Research Network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond T.","family":"Chung","sequence":"additional","affiliation":[{"name":"and the Hepatitis B Research Network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian M","family":"Di Bisceglie","sequence":"additional","affiliation":[{"name":"and the Hepatitis B Research Network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Lisker-Melman","sequence":"additional","affiliation":[{"name":"and the Hepatitis B Research Network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry L. 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