The prevalence of primary biliary cholangitis (PBC) in the U.S. may be high and variable between regions, according to a study recently published in the journal Hepatology.
Disease prevalence refers to its frequency, as the number of diagnosed patients per 100,000 people at a particular point in time.
“The greatest burden of PBC exists in major cities, which may be best equipped to address treatment needs given the presence of major university hospitals. The high prevalence in more rural areas leaves several unanswered questions regarding the potential presence of environmental and genetic factors which may be driving highly localized spikes in prevalence, as well as access to specialty care for treating rare diseases,” the researchers wrote.
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The study included 41,426 adult patients with PBC found in the Komodo Health claims database in 2021. The researchers took note of the patients’ age, sex and race/ethnicity and adjusted PBC prevalence by sex, age and census population at the three-digit zip-code tabulation area (ZCTA3) level. They created heat maps for absolute number and prevalence by ZCTA3.
According to the results, the majority of patients were female (83%), with a mean age of 61.9 years. Of the 31,806 (76.8%) patients with known race/ethnicity, 67.6% of patients were White, 16.9% Hispanic/ Latino, 7.6% Black, and 3.5% Asian/Pacific Islander. There were 40.9 patients diagnosed with PBC per 100,000 adult Americans and 105,506 adult patients nationally.
The highest absolute number of patients with PBC was found in the largest metropolitan statistical areas such as New York, Los Angeles, Chicago and Houston. However, the highest number of patients per 100,000 was found in rural areas in the Midwest, with pockets in the West and along the Appalachians in the Mid-Atlantic.
“PBC prevalence in the U.S. has been estimated from small regional databases. However, environmental and genetic factors vary considerably by region, potentially influencing prevalence. Our objective was to estimate a robust national prevalence while quantifying regional variability,” the researchers added.
