{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T23:43:15Z","timestamp":1793662995239,"version":"4.5.1"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Underdiagnosis of chronic hepatitis B (CHB) remains a major problem in the United States (USA), with &gt;\u200980% of CHB patients remaining undiagnosed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine the prevalence of late diagnosis of CHB and resultant liver complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective analysis of the Truven MarketScan database (1\/2007\u201312\/2021) included more than 250 million privately insured persons. The index date was the date of the first liver complication (cirrhosis, hepatocellular carcinoma [HCC], or liver transplant). Late diagnosis was defined as the diagnosis of CHB 2\u2009years prior to or after the index date. Adults aged\u2009\u2265\u200918\u2009years with a diagnosis of CHB and\u2009\u2265\u200912\u2009months of insurance coverage prior to the index date were included. Exclusion criteria included &gt;\u200990\u2009days break of insurance coverage within 12\u2009months before the index date and receipt of nonliver transplant within 5\u2009years of the index date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>2608 persons met inclusion criteria with a mean age of 54.8\u2009years and 70.3% were male. 1999 (76.6%) had a late diagnosis of CHB, of whom 889 (44.5%) were diagnosed at or within 6\u2009months of the index complication, and 1510 (75.5%) did not have a documented visit with a provider to the index date. Late diagnosis rate remained stable between 2009 (73.8%) and 2017 (74.2%, <jats:italic>p\u2010trend<\/jats:italic>\u2009=\u20090.937<jats:italic>)<\/jats:italic>. In the late diagnosis group, complications included cirrhosis (<jats:italic>n<\/jats:italic>\u2009=\u20091820, 91.0%), decompensated cirrhosis (<jats:italic>n<\/jats:italic>\u2009=\u20091630, 81.5%), HCC (<jats:italic>n<\/jats:italic>\u2009=\u2009615, 30.8%) and liver transplant (<jats:italic>n<\/jats:italic>\u2009=\u2009288, 14.4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Approximately three\u2010fourths of patients diagnosed with CHB in the USA had a late diagnosis. Increased screening efforts must be made to prevent poor clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.70193","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T13:04:17Z","timestamp":1748264657000},"page":"340-348","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Late Diagnosis of Chronic Hepatitis B in the United States: A Population\u2010Based, Retrospective Cohort Study From 2007 to 2021"],"prefix":"10.1111","volume":"62","author":[{"given":"Michael H.","family":"Le","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Stanford California USA"},{"name":"The Robert Larner MD College of Medicine at the University of Vermont  Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne K.","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KeeSeok","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramsey","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Stanford California USA"},{"name":"Division of Gastroenterology and Hepatology VA Palo Alto Health Care System  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6275-4989","authenticated-orcid":false,"given":"Mindie H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Stanford California USA"},{"name":"Department of Epidemiology and Population Health Stanford School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Global Hepatitis Report 2024: Action for Access in Low and Middle\u2010Income Countries","year":"2024"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20101253(22)00124\u20108"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575\u2010023\u201000759\u20102"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4551"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20101253(23)00156\u20105"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30831"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000081"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.08.019"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31557"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.1844"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7201a1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.06.025"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14670"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.04.042"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10754\u2010021\u201009296\u20104"},{"key":"e_1_2_9_17_1","unstructured":"Association AH \u201cThe Top 10 Reasons Men Put Off Doctor Visits and 10 Reasons Why They Should Go.\u201d"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010014\u20103089\u20101"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/17437199.2013.840954"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.04.026"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13784"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/21501319231166921"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.2196\/13313"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeph.2024.202744"}],"container-title":["Alimentary Pharmacology &amp; 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