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Hepatitis C in Black Individuals in the USA Review
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JAMA. Published online November 9, 2023
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Conclusions
In the US, the prevalence of HCV is higher in people who are Black than in people who are not Black. Point-of-care HCV tests, patient navigation, electronic health record prompts, and unrestricted access to HCV treatment in community-based settings have potential to increase diagnosis and treatment of HCV and improve outcomes in people who are Black.
• treatment initiation was significantly less common among 2535 Black individuals compared with 9006 White individuals (aHR, 0.71
• number of people treated for HCV decreased from 164 232 in 2015 to 83 740 in 2020
• While people from all races and ethnicities experienced increased rates of newly diagnosed acute HCV infections between 2015 and 2021, Black individuals experienced the greatest percentage increase
• HCV can be cured by antiviral treatment with oral direct-acting antivirals (DAAs).
HCV Epidemiology: HCV infection occurs primarily by percutaneous exposure to contaminated blood. In the US, most HCV infections (57%) are associated with injection drug use.3 HCV infection is associated with high-risk sexual practices (including those resulting in bleeding or damage to mucosa and drug use during sex) primarily among men who have sex with men living with HIV.5 Mother to child transmission of HCV occurs in 5.8% (95% CI, 4.2%-7.8%) of infants born to mothers with HCV infection and 10.8% (95% CI, 7.6%-15.2%) of infants born to mothers with HCV and HIV infection. Progression of liver disease to cirrhosis occurs in 20% to 30% of people with chronic HCV infection over 25 to 30 years.7 Individuals with HCV cirrhosis have increased risk of HCC, hepatic decompensation, and death. The natural history of HCV is influenced by host, viral, and environmental factors, and HCV can be cured by antiviral treatment with oral direct-acting antivirals (DAAs).
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