Multicenter review of liver transplant for hepatitis B‐related liver disease: disparities in gender and ethnicity

Campsen, Jeffrey; Zimmerman, Michael A.; Trotter, James F.; Hong, Johnny C.; Freise, Chris E.; Brown, Robert S.; Cameron, Andrew M.; Ghobrial, Rafik M.; Kam, Igal; Busuttil, Ronald W.; Saab, Sammy; Holt, Curtis; Emond, Jean C.; Stiles, Jessica B.; Lukose, Thresiamma; Chang, Matthew S.; Klintmalm, Göran B.

doi:10.1111/ctr.12224

Cited by 11 publications

(9 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Because of the heterogeneous nature of HBV therapies over the time period of this study, we divided the patients into 3 eras: (1) 1985‐1994, (2) 1995‐2004, and (3) 2005‐2010. Each era was unique and represented a dominant HBV therapy …”

Section: Methodsmentioning

confidence: 99%

“…Previous research suggests that the successful treatment of HBV is associated with improved survival and a reduction in HCC recurrence after transplantation. Observational studies suggest a link between the reemergence of HBV and HCC recurrence in the posttransplant setting . Whether the combination of HBIG and antivirals has a direct antineoplastic effect that is distinct from the suppression of viral replication is not known.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Liver transplantation for hepatitis B liver disease and concomitant hepatocellular carcinoma in the United States With hepatitis B immunoglobulin and nucleoside/nucleotide analogues

et al. 2013

Self Cite

View full text Add to dashboard Cite

7Methodist Hospital, Houston, TX Reinfection with hepatitis B virus (HBV) after liver transplantation (LT) may favor the recurrence of hepatocellular carcinoma (HCC), and combination therapy with hepatitis B immunoglobulin (HBIG) and nucleoside/nucleotide analogues may reduce HBV recurrence after LT. To test associations between HBV, HCC, and survival, we performed a retrospective chart review of patients undergoing LT for HBV between January 1985 and December 2010 at 7 US transplant centers. After we divided the patients into 3 eras based on evolving strategies in antiviral therapy (1985-1994, 1995-2004, and 2005-2010), we reviewed 16 variables to determine whether there were associations between survival and HCC recurrence. Seven hundred thirty-eight patients underwent transplantation for HBV, and 354 (48.0%) had concomitant HCC, which recurred in 58 patients (16.4%). Three-year survival was much better in era 3 versus era 1 (87% versus 40%, P 5 0.001), and the incidence of HCC recurrence was lower (12% versus 29%, P 5 0.009). The lungs were the most frequent first site of HCC recurrence, and they were followed by the liver. A multivariate analysis showed that HBV reinfection, HCC recurrence, and HBIG use were associated with worse survival (P < 0.001, P < 0.001, and P 5 0.002, respectively); HCC recurrence and stage 3 HCC, among other factors, were associated with HBV reinfection (P < 0.001 and P 5 0.004); and stage 3 HCC, vascular invasion of the explanted tumor, and post-LT chemotherapy were associated with HCC recurrence (P 5 0.008, P < 0.001, and P < 0.001, respectively). Patients with HBV reinfection were 3.6 times more likely than patients without HBV to have HCC recurrence. These data suggest further study of attempts at LT for patients with HBV and HCC beyond the Milan criteria if their HBV is aggressively and successfully treated. Liver Transpl 19:1020-1029, 2013. V C 2013 AASLD.Received November 14, 2012; accepted June 3, 2013.Orthotopic liver transplantation (LT) has become the preferred treatment for patients with hepatitis B virus (HBV)-mediated end-stage liver disease.1-3 Although HBV was originally a contraindication to transplantation, now the 5-year survival rates following LT for HBV-related disease are similar to those for other

show abstract

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Liver transplantation for hepatitis B liver disease and concomitant hepatocellular carcinoma in the United States With hepatitis B immunoglobulin and nucleoside/nucleotide analogues

et al. 2013

Self Cite

View full text Add to dashboard Cite

show abstract

“…A study from 2009, including 274 patients, suggested comparable post-transplant outcomes for African Americans when compared to other racial groups [28]. A more contemporary study of 738 patients from 10 academic centers, suggested that African Americans had higher rates of mortality, a finding for which the reasoning remains unclear [29]. …”

Section: Towards Eliminating Viral Hepatitismentioning

confidence: 99%

Ethnic Disparities in Chronic Hepatitis B Infection: African Americans and Hispanic Americans

Forde

2017

Curr Hepatology Rep

View full text Add to dashboard Cite

Chronic infection with hepatitis B affects more than 240 million persons worldwide and is a major public health concern. Despite national and global initiatives to promote hepatitis B elimination, including newborn vaccination, catch up vaccination in adolescents and high-risk adults, screening of the blood supply and treatment of those in need, both new infections and a reservoir of chronic infections continue to result in morbidity and mortality. As with many chronic diseases, racial and ethnic disparities are seen in hepatitis B virus infection. Purpose of Review The goal of this review is to synthesize the data concerning the burden of hepatitis B infection in African Americans and Hispanics, two racial/ethnic groups in the United States who encounter barriers in access to care, low engagement in care and low utilization of diagnostic and treatment services. Recent Findings Recent data, though sparse in certain areas, continue to suggest differences in rates of incidence and prevalence of hepatitis B virus infection in African Americans, and differences in screening, specialty referral and initiation of therapy for African Americans and Hispanics. Data are lacking about differences in liver disease progression and manifestations in both African Americans and Hispanics. Summary Disparities in hepatitis B diagnosis, disease management, treatment and prevention remain for African Americans and Hispanics. These disparities require a commitment from governmental and public health organizations. The efforts should include increasing vaccination in those most susceptible to infection, screening those at highest risk for infection, initiating antiviral therapy in those who require it and monitoring for liver-related complications, such as decompensated cirrhosis and hepatocellular carcinoma in the chronically infected. This multi-pronged approach is necessary to realize hepatitis B elimination.

show abstract

“…Differences in outcome after transplant may be biologically driven and may also be related to medical compliance. Blacks and women with HBV had worse long-term outcomes post-transplant compared to other races[ 91 ]. Recurrence of HBV was significant for Blacks even ten years post liver transplant, affecting the survival rate.…”

Section: Liver Transplantationmentioning

confidence: 99%

Current status of disparity in liver disease

Sempokuya¹,

Warner²,

Azawi³

et al. 2022

World J Hepatol

View full text Add to dashboard Cite

Disparities have emerged as an important issue in many aspects of healthcare in developed countries and may be based on race, ethnicity, sex, geographical location, and socioeconomic status. For liver disease specifically, these potential disparities can affect access to care and outcome in viral hepatitis, chronic liver disease, and hepatocellular carcinoma. Shortages in hepatologists and medical providers versed in liver disease may amplify these disparities by compromising early detection of liver disease, surveillance for hepatocellular carcinoma, and prompt referral to subspecialists and transplant centers. In the United States, continued efforts have been made to address some of these disparities with better education of healthcare providers, use of telehealth to enhance access to specialists, reminders in electronic medical records, and modifying organ allocation systems for liver transplantation. This review will detail the current status of disparities in liver disease and describe current efforts to minimize these disparities.

show abstract

Multicenter review of liver transplant for hepatitis B‐related liver disease: disparities in gender and ethnicity

Cited by 11 publications

References 36 publications

Liver transplantation for hepatitis B liver disease and concomitant hepatocellular carcinoma in the United States With hepatitis B immunoglobulin and nucleoside/nucleotide analogues

Liver transplantation for hepatitis B liver disease and concomitant hepatocellular carcinoma in the United States With hepatitis B immunoglobulin and nucleoside/nucleotide analogues

Ethnic Disparities in Chronic Hepatitis B Infection: African Americans and Hispanic Americans

Current status of disparity in liver disease

Contact Info

Product

Resources

About