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Racial and Ethnic Disparities in Hepatitis C Care in Reproductive-Aged Women With Opioid Use Disorder: 10% HCV treatment rates; African-Americans 25% less likely to be screened
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Download the PDF here
Download the PDF here
15 December 2024
Asian and black/African American individuals each had lower probabilities of HCV antibody testing compared with white individuals (RR, 0.77 [95% CI, .62–.96] and 0.76 [.63–.92], respectively). Yet black/African American individuals, compared with white individuals, had an 11% higher probability of HCV infection if HCV antibody positive
Abstract
Background
In the United States, hepatitis C virus (HCV) diagnoses among reproductive-aged women are increasing amidst the ongoing opioid and drug overdose epidemic. While previous studies document racial and ethnic disparities in HCV testing and treatment in largely male populations, to our knowledge no national studies analyze these outcomes in reproductive-aged women with opioid use disorder (OUD).
Methods
We analyzed data from a cohort of reproductive-aged women (aged 15–44 years) with diagnosed OUD captured in the TriNetX Research Network, a network of electronic health records from across the United States. Using a log-binomial model, we assessed differences in achieving HCV cascade of care stages (HCV antibody testing, HCV infection [positive HCV RNA test result], linkage to care, and HCV treatment) by race and ethnicity.
Results
From 2014 to 2022, 44.6% of the cohort were tested for HCV antibody. Asian and black/African American individuals had a lower probability of having an HCV antibody test than white individuals (risk ratio, 0.77 [95% confidence interval, .62–.96] and 0.76 [.63–.92], respectively). Among those with HCV infection, only 9.1% were treated with direct-acting antivirals. Hispanic/Latinx individuals had a higher probability of treatment than non-Hispanic/Latinx individuals (risk ratio, 1.63 [95% confidence interval, 1.01–2.61]).
Conclusions
Few reproductive-aged women with OUD are tested or treated for HCV. Disparities by race and ethnicity in HCV testing further exacerbate the risk of perinatal transmission and disease progression among minoritized communities. Interventions are needed to improve overall rates of and equity in HCV screening and treatment for reproductive-aged women.
Figure 1.
Hepatitis C virus (HCV) cascade of care (CoC) by race and ethnicity, among women of reproductive age with opioid use disorder, stratified by race (A, B) and ethnicity (C, D) (TriNetX Research Network, 2014–2022). Abbreviations: AA, African American; Ab, antibody; AIAN, American Indian or Alaska Native; DAA, direct-acting antiviral; SVR, sustained virologic response.
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