Racial Disparities in HCV Incidence and Treatment Outcomes
Jasenka Piljac Žegarac, PhD
December 01, 2017
In an interview with Infectious Disease Advisor, Elana Rosenthal, MD, assistant professor of medicine at the Institute of Human Virology, University of Maryland School of Medicine in Baltimore, and Paul H. Naylor, PhD, adjunct associate professor at the Department of Internal Medicine/Gastroenterology, Wayne State University School of Medicine in Detroit, Michigan, discussed the latest insights on racial disparities in HCV incidence and treatment outcomes.
Infectious Disease Advisor: According to research to date, which group or groups of HCV-infected individuals are at highest risk for all-cause mortality resulting from HCV?
Dr Rosenthal: A recent study evaluated National Health and Nutrition Examination Survey data through 2011 and identified that Mexican-Americans with HCV had a significantly higher all-cause mortality compared with non-Hispanic blacks and non-Hispanic whites.3 It was postulated that this disparity may be related to higher risk for hepatocellular carcinoma in this population, or higher rates of lack of insurance. This highlights an important point: that in the era of direct-acting antivirals, the biggest risk for mortality lies in the inability to access curative therapy. In the United States, marginalized populations such as people who use drugs, incarcerated individuals, patients with limited insurance coverage, or those without medical insurance are most likely to suffer long-term consequences of hepatitis C, because they are the least likely to access HCV treatment.
Dr Rosenthal: A recent study evaluated National Health and Nutrition Examination Survey data through 2011 and identified that Mexican-Americans with HCV had a significantly higher all-cause mortality compared with non-Hispanic blacks and non-Hispanic whites.3 It was postulated that this disparity may be related to higher risk for hepatocellular carcinoma in this population, or higher rates of lack of insurance. This highlights an important point: that in the era of direct-acting antivirals, the biggest risk for mortality lies in the inability to access curative therapy. In the United States, marginalized populations such as people who use drugs, incarcerated individuals, patients with limited insurance coverage, or those without medical insurance are most likely to suffer long-term consequences of hepatitis C, because they are the least likely to access HCV treatment.
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