Observational studyInfectious diseases of poverty2026
Liver fibrosis severity in chronic hepatitis B is associated with area-level rather than individual socioeconomic disadvantage: a nationwide multicentre study in Türkiye.
Observational study in Infectious diseases of poverty, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
28 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSocioeconomic disadvantage may influence the chronic hepatitis B (CHB) care continuum and the stage at which clinically relevant liver disease is recognised. However, evidence linking both individual- and area-level socioeconomic disadvantage to histologically assessed liver fibrosis in CHB remains limited. We examined whether socioeconomic disadvantage at the individual and area levels was associated with liver fibrosis severity in adults with CHB in Türkiye.
methodsIn this nationwide multicentre observational study, adults with CHB who underwent liver biopsy in routine care between 1 January 2019 and 31 December 2024 across 24 centres in Türkiye were screened. Clinical and histopathological data were obtained retrospectively from medical records, while socioeconomic data were collected after biopsy through structured face-to-face interviews. Fibrosis was staged using the Ishak system. Individual socioeconomic indicators and province-level categories of the socioeconomic development index (SEDI) were examined. The primary analysis used ordinal logistic regression. Supportive analyses included multivariable logistic regression, 1:1 propensity score matching with conditional logistic regression, overlap weighting, likelihood-ratio tests for interaction, chi-square or Fisher's exact tests, Kruskal-Wallis tests, and Wilcoxon rank-sum tests, with Benjamini-Hochberg adjustment for post-hoc comparisons.
resultsThe analytic cohort included 956 adults, of whom 53.7% were male. Mild fibrosis (Ishak 0-2) was present in 73.1%, moderate fibrosis (3-4) in 21.7%, and advanced fibrosis/cirrhosis (5-6) in 5.2%. In multivariable ordinal regression, higher fibrosis stage was associated with older age at biopsy (adjusted OR = 1.12 per 10-year increase, 95% CI: 1.02-1.24; P = 0.019), longer travel time to a centre capable of CHB follow-up (adjusted OR = 1.53 per category, 95% CI: 1.30-1.79; P < 0.001), longer duration of residence in the current place of residence (adjusted OR = 1.21 per 5-year increase, 95% CI: 1.03-1.42; P = 0.023), and lower residential socioeconomic development (adjusted OR = 1.97 per one-level decrease, 95% CI: 1.82-2.15; P < 0.001). In matched and overlap-weighted comparisons of SEDI 6 versus SEDI 1, the corresponding estimates were OR = 26.00 (95% CI: 8.21-82.37; P < 0.001) and OR = 24.75 (95% CI: 8.96-68.36; P < 0.001), respectively.
conclusionsLiver fibrosis severity in adults with CHB was associated more consistently with area-level socioeconomic disadvantage of the current place of residence than with birthplace socioeconomic context or most individual socioeconomic indicators. These findings support a social epidemiological interpretation in which place-based disadvantage may be more closely linked to fibrosis severity at clinical presentation, potentially through unequal access to timely follow-up and specialist assessment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.