Skip to main content

Julius Middleton Wilder

Associate Professor of Medicine
Medicine, Gastroenterology
Box 90120, Durham, NC 27708-0120
200 Morris Street, Durham, NC 27701
Office hours Tuesdays - 9am- 5pm
Thursdays- 9am- 5pm
Fridays- 9am - 5pm  

Selected Publications


Pragmatic strategies to address health disparities along the continuum of care in chronic liver disease.

Journal Article Hepatol Commun · May 1, 2024 Racial, ethnic, and socioeconomic disparities exist in the prevalence and natural history of chronic liver disease, access to care, and clinical outcomes. Solutions to improve health equity range widely, from digital health tools to policy changes. The cur ... Full text Link to item Cite

Racial and ethnic disparities in metabolic dysfunction-associated steatotic liver disease

Journal Article Metabolism and Target Organ Damage · January 1, 2024 Metabolic dysfunction-associated steatotic liver disease (MASLD) has an increasing prevalence, morbidity, and mortality both within the United States and globally. Here, we review newer evidence demonstrating racial and ethnic disparities that exist in the ... Full text Cite

Characterization of social determinants of health of a liver transplant referral population.

Journal Article Liver Transpl · November 1, 2023 Disparities exist in referral and access to the liver transplant (LT) waitlist, and social determinants of health (SDOH) are increasingly recognized as important factors driving health inequities, including in LT. The SDOH of potential transplant candidate ... Full text Link to item Cite

Social Media and Hepatology

Journal Article Gastroenterology and Hepatology · September 1, 2023 Cite

Confronting Disparities in Telehepatology Research.

Journal Article Clin Gastroenterol Hepatol · June 2023 Full text Link to item Cite

Access to technology to support telehealth in areas without specialty care for liver disease.

Journal Article Hepatology · January 1, 2023 BACKGROUND AND AIMS: Telehealth may be a successful strategy to increase access to specialty care for liver disease, but whether the areas with low access to care and a high burden of liver-related mortality have the necessary technology access to support ... Full text Link to item Cite

Patient Disparities in Consent for HCV NAT plus Solid Organ Transplant

Conference AMERICAN JOURNAL OF TRANSPLANTATION · 2023 Cite

A scoping review of inequities in access to organ transplant in the United States.

Journal Article Int J Equity Health · February 12, 2022 BACKGROUND: Organ transplant is the preferred treatment for end-stage organ disease, yet the majority of patients with end-stage organ disease are never placed on the transplant waiting list. Limited access to the transplant waiting list combined with the ... Full text Link to item Cite

Racial and Socioeconomic Disparities in Utilization of Telehealth in Patients with Liver Disease During COVID-19.

Journal Article Dig Dis Sci · January 2022 BACKGROUND AND AIMS: The coronavirus disease 2019 (COVID-19) pandemic resulted in a rapid expansion of telehealth services in hepatology. However, known racial and socioeconomic disparities in internet access potentially translate into barriers for the use ... Full text Link to item Cite

Racial disparities in transjugular intrahepatic portosystemic shunt procedure outcomes.

Journal Article BMJ Open Gastroenterol · January 2022 OBJECTIVE: The transjugular intrahepatic portosystemic shunt (TIPS) procedure is an important intervention for management of complications of portal hypertension. The objective of this study was to identify predictors of mortality from the TIPS procedure w ... Full text Link to item Cite

Racial disparities in liver cancer: Evidence for a role of environmental contaminants and the epigenome.

Journal Article Front Oncol · 2022 Liver cancer incidence has tripled since the early 1980s, making this disease one of the fastest rising types of cancer and the third leading cause of cancer-related deaths worldwide. In the US, incidence varies by geographic location and race, with the hi ... Full text Open Access Link to item Cite

Equitable Access to Liver Transplant: Bridging the Gaps in the Social Determinants of Health.

Journal Article Hepatology · November 2021 The COVID-19 pandemic and social justice movement have highlighted the impact of social determinants of health (SDOH) and structural racism in the United States on both access to care and patient outcomes. With the evaluation for liver transplantation bein ... Full text Link to item Cite

COVID-19 and the Uncovering of Health Care Disparities in the United States, United Kingdom and Canada: Call to Action.

Journal Article Hepatol Commun · October 2021 The coronavirus disease 2019 (COVID-19) pandemic created a crisis that disproportionately affected populations already disadvantaged with respect to access to health care systems and adequate medical care and treatments. Understanding how and where health ... Full text Link to item Cite

Health Equity and Telemedicine in Gastroenterology and Hepatology.

Journal Article Clin Gastroenterol Hepatol · August 2021 Full text Link to item Cite

Socioeconomic Status Is Associated with the Risk of Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt Creation.

Journal Article J Vasc Interv Radiol · July 2021 PURPOSE: To determine whether socioeconomic status (SES) is associated with hepatic encephalopathy (HE) risk after transjugular intrahepatic portosystemic shunt (TIPS) creation. MATERIALS AND METHODS: This single-institution retrospective study included 36 ... Full text Link to item Cite

Why do patients with chronic hepatitis C drink alcohol? An examination of pain, depression and drinking motives.

Journal Article J Viral Hepat · May 2021 Alcohol consumption in the setting of chronic HCV is associated with accelerated progression towards cirrhosis, increased risk of hepatocellular carcinoma and higher mortality. This analysis contextualizes how sociodemographic factors, chronic pain and dep ... Full text Link to item Cite

Pragmatic strategies to address health disparities along the continuum of care in chronic liver disease.

Journal Article Hepatol Commun · May 1, 2024 Racial, ethnic, and socioeconomic disparities exist in the prevalence and natural history of chronic liver disease, access to care, and clinical outcomes. Solutions to improve health equity range widely, from digital health tools to policy changes. The cur ... Full text Link to item Cite

Racial and ethnic disparities in metabolic dysfunction-associated steatotic liver disease

Journal Article Metabolism and Target Organ Damage · January 1, 2024 Metabolic dysfunction-associated steatotic liver disease (MASLD) has an increasing prevalence, morbidity, and mortality both within the United States and globally. Here, we review newer evidence demonstrating racial and ethnic disparities that exist in the ... Full text Cite

Characterization of social determinants of health of a liver transplant referral population.

Journal Article Liver Transpl · November 1, 2023 Disparities exist in referral and access to the liver transplant (LT) waitlist, and social determinants of health (SDOH) are increasingly recognized as important factors driving health inequities, including in LT. The SDOH of potential transplant candidate ... Full text Link to item Cite

Social Media and Hepatology

Journal Article Gastroenterology and Hepatology · September 1, 2023 Cite

Confronting Disparities in Telehepatology Research.

Journal Article Clin Gastroenterol Hepatol · June 2023 Full text Link to item Cite

Access to technology to support telehealth in areas without specialty care for liver disease.

Journal Article Hepatology · January 1, 2023 BACKGROUND AND AIMS: Telehealth may be a successful strategy to increase access to specialty care for liver disease, but whether the areas with low access to care and a high burden of liver-related mortality have the necessary technology access to support ... Full text Link to item Cite

Patient Disparities in Consent for HCV NAT plus Solid Organ Transplant

Conference AMERICAN JOURNAL OF TRANSPLANTATION · 2023 Cite

A scoping review of inequities in access to organ transplant in the United States.

Journal Article Int J Equity Health · February 12, 2022 BACKGROUND: Organ transplant is the preferred treatment for end-stage organ disease, yet the majority of patients with end-stage organ disease are never placed on the transplant waiting list. Limited access to the transplant waiting list combined with the ... Full text Link to item Cite

Racial and Socioeconomic Disparities in Utilization of Telehealth in Patients with Liver Disease During COVID-19.

Journal Article Dig Dis Sci · January 2022 BACKGROUND AND AIMS: The coronavirus disease 2019 (COVID-19) pandemic resulted in a rapid expansion of telehealth services in hepatology. However, known racial and socioeconomic disparities in internet access potentially translate into barriers for the use ... Full text Link to item Cite

Racial disparities in transjugular intrahepatic portosystemic shunt procedure outcomes.

Journal Article BMJ Open Gastroenterol · January 2022 OBJECTIVE: The transjugular intrahepatic portosystemic shunt (TIPS) procedure is an important intervention for management of complications of portal hypertension. The objective of this study was to identify predictors of mortality from the TIPS procedure w ... Full text Link to item Cite

Racial disparities in liver cancer: Evidence for a role of environmental contaminants and the epigenome.

Journal Article Front Oncol · 2022 Liver cancer incidence has tripled since the early 1980s, making this disease one of the fastest rising types of cancer and the third leading cause of cancer-related deaths worldwide. In the US, incidence varies by geographic location and race, with the hi ... Full text Open Access Link to item Cite

Equitable Access to Liver Transplant: Bridging the Gaps in the Social Determinants of Health.

Journal Article Hepatology · November 2021 The COVID-19 pandemic and social justice movement have highlighted the impact of social determinants of health (SDOH) and structural racism in the United States on both access to care and patient outcomes. With the evaluation for liver transplantation bein ... Full text Link to item Cite

COVID-19 and the Uncovering of Health Care Disparities in the United States, United Kingdom and Canada: Call to Action.

Journal Article Hepatol Commun · October 2021 The coronavirus disease 2019 (COVID-19) pandemic created a crisis that disproportionately affected populations already disadvantaged with respect to access to health care systems and adequate medical care and treatments. Understanding how and where health ... Full text Link to item Cite

Health Equity and Telemedicine in Gastroenterology and Hepatology.

Journal Article Clin Gastroenterol Hepatol · August 2021 Full text Link to item Cite

Socioeconomic Status Is Associated with the Risk of Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt Creation.

Journal Article J Vasc Interv Radiol · July 2021 PURPOSE: To determine whether socioeconomic status (SES) is associated with hepatic encephalopathy (HE) risk after transjugular intrahepatic portosystemic shunt (TIPS) creation. MATERIALS AND METHODS: This single-institution retrospective study included 36 ... Full text Link to item Cite

Why do patients with chronic hepatitis C drink alcohol? An examination of pain, depression and drinking motives.

Journal Article J Viral Hepat · May 2021 Alcohol consumption in the setting of chronic HCV is associated with accelerated progression towards cirrhosis, increased risk of hepatocellular carcinoma and higher mortality. This analysis contextualizes how sociodemographic factors, chronic pain and dep ... Full text Link to item Cite

Addressing Social Determinants of Liver Disease During the COVID-19 Pandemic and Beyond: A Call to Action.

Journal Article Hepatology · February 2021 The COVID-19 pandemic has exposed healthcare inequities in the USA and highlighted the importance of social conditions in shaping the health of persons. In the field of hepatology, social determinants of health (SDOH) are closely linked to disparities in l ... Full text Link to item Cite

Financial Toxicity and Its Prevalence in Cirrhosis

Conference AMERICAN JOURNAL OF GASTROENTEROLOGY · 2021 Cite

A Randomized Controlled Trial of an Integrated Alcohol Reduction Intervention in Patients With Hepatitis C Infection.

Journal Article Hepatology · June 2020 BACKGROUND AND AIMS: Hepatitis C virus (HCV) and alcohol use are patient risk factors for accelerated fibrosis progression, yet few randomized controlled trials have tested clinic-based alcohol interventions. APPROACH AND RESULTS: A total of 181 patients w ... Full text Link to item Cite

Transplant Outcomes in Older Patients With Nonalcoholic Steatohepatitis Compared to Alcohol-related Liver Disease and Hepatitis C.

Journal Article Transplantation · June 2020 BACKGROUND: Patients with nonalcoholic steatohepatitis (NASH) are waitlisted at older ages than individuals with other liver diseases, but the effect of age on liver transplantation (LT) outcomes in this population and whether it differs from other etiolog ... Full text Link to item Cite

Unclear Statement.

Journal Article JAMA · July 23, 2019 Full text Link to item Cite

Multi-disciplinary approach to perioperative risk assessment and post-transplant management for liver transplantation in a patient at risk for Brugada syndrome.

Journal Article J Perioper Pract · May 2019 Brugada syndrome, an autosomal dominant genetic disorder, is characterised by abnormal electrocardiogram findings and increased risk of ventricular tachyarrhythmias and sudden cardiac death. Our report describes the multi-disciplinary perioperative managem ... Full text Link to item Cite

Acute Intermittent Porphyria: Current Perspectives And Case Presentation.

Journal Article Ther Clin Risk Manag · 2019 Acute intermittent porphyria (AIP) is an autosomal dominant metabolic disorder characterized by a deficiency in heme biosynthesis. Heme biosynthesis occurs throughout the body, but it is most prominent in the erythroblastic system and liver. AIP is a hepat ... Full text Open Access Link to item Cite

The impact of human leukocyte antigen donor and recipient serotyping and matching on liver transplant graft failure in primary sclerosing cholangitis, autoimmune hepatitis, and primary biliary cholangitis.

Journal Article Clin Transplant · October 2018 Human leukocyte antigen (HLA) serotyping is not considered to have significant impact on liver graft survival and does not factor into U.S. organ allocation. Immune-related liver diseases such as primary sclerosing cholangitis (PSC), autoimmune hepatitis ( ... Full text Link to item Cite

TIPS Outcomes According to Race and Ethnicity

Conference AMERICAN JOURNAL OF GASTROENTEROLOGY · October 1, 2018 Link to item Cite

The Hepatitis C-Alcohol Reduction Treatment (Hep ART) intervention: Study protocol of a multi-center randomized controlled trial.

Journal Article Contemp Clin Trials · September 2018 INTRODUCTION: Among patients with hepatitis C virus (HCV) infection, alcohol synergistically increases the risk of cirrhosis, hepatocellular carcinoma, and death. Randomized controlled trials of integrated models of HCV-alcohol treatment have been recommen ... Full text Link to item Cite

Hepatitis C Virus Elimination in the Human Immunodeficiency Virus-Coinfected Population: Leveraging the Existing Human Immunodeficiency Virus Infrastructure.

Journal Article Infect Dis Clin North Am · June 2018 The objective of this review is to consider how existing human immunodeficiency virus (HIV) infrastructure may be leveraged to inform and improve hepatitis C virus (HCV) treatment efforts in the HIV-HCV coinfected population. Current gaps in HCV care relev ... Full text Link to item Cite

Direct acting antivirals for the treatment of hepatitis C in ethnic minority populations.

Journal Article Expert Opin Pharmacother · April 2018 INTRODUCTION: Direct acting antivirals (DAA's) have revolutionized the treatment of hepatitis C (HCV). However, questions persist concerning their efficacy in minority populations. AREAS COVERED: In this review, the authors review outcomes for treatment of ... Full text Link to item Cite

Direct-Acting Antivirals Improve Access to Care and Cure for Patients With HIV and Chronic HCV Infection.

Journal Article Open Forum Infect Dis · January 2018 BACKGROUND: Direct-acting antivirals (DAA) as curative therapy for hepatitis C virus (HCV) infection offer >95% sustained virologic response (SVR), including in patients with human immunodeficiency virus (HIV) infection. Despite improved safety and efficac ... Full text Open Access Link to item Cite

Differences in Phenotypes and Liver Transplantation Outcomes by Age Group in Patients with Primary Sclerosing Cholangitis.

Journal Article Dig Dis Sci · November 2017 BACKGROUND: There is increasing evidence for a heterogeneity of phenotypes in primary sclerosing cholangitis (PSC), but differences across the age spectrum in adults with PSC have not been well characterized. AIMS: To characterize phenotypic variations and ... Full text Link to item Cite

Implementing a Health Equity Agenda at the Duke Cancer Institute

Journal Article Oncology Issues · September 1, 2016 Open Access Cite

Role of patient factors, preferences, and distrust in health care and access to liver transplantation and organ donation.

Journal Article Liver Transpl · July 2016 Despite major improvements in access to liver transplantation (LT), disparities remain. Little is known about how distrust in medical care, patient preferences, and the origins shaping those preferences contribute to differences surrounding access. We perf ... Full text Open Access Link to item Cite

Safety and efficacy of ledipasvir-sofosbuvir in black patients with hepatitis C virus infection: A retrospective analysis of phase 3 data.

Journal Article Hepatology · February 2016 UNLABELLED: Black patients chronically infected with genotype 1 hepatitis C virus (HCV) have historically had lower rates of response to interferon-based treatment than patients of other races. In the phase 3 ION program, the single-tablet regimen of the N ... Full text Open Access Link to item Cite

A Systematic Review of Race and Ethnicity in Hepatitis C Clinical Trial Enrollment.

Journal Article J Natl Med Assoc · February 2016 The African American/Black population in the United States (US) is disproportionately affected by hepatitis C virus (HCV) and has lower response rates to current treatments. This analysis evaluates the participation of African American/Blacks in North Amer ... Full text Open Access Link to item Cite

Strategies for treating chronic HCV infection in patients with cirrhosis: latest evidence and clinical outcomes.

Journal Article Ther Adv Chronic Dis · November 2015 The burden of chronic hepatitis C virus (HCV) infection is significant and growing. HCV is considered one of the leading causes of liver disease worldwide and the leading cause of liver transplantation globally. While those infected is estimated in the hun ... Full text Open Access Link to item Cite

Fibroscan.

Journal Article Clin Liver Dis (Hoboken) · November 2014 Full text Link to item Cite

The clinical utility of FibroScan(®) as a noninvasive diagnostic test for liver disease.

Journal Article Med Devices (Auckl) · 2014 An important aspect of managing chronic liver disease is assessing for evidence of fibrosis. Historically, this has been accomplished using liver biopsy, which is an invasive procedure associated with risk for complications and significant sampling and obs ... Full text Open Access Link to item Cite