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Abstract Details
Late presenters among minority patients with chronic hepatitis C infection in the USA
Int J Public Health. 2020 Sep;65(7):1181-1191. doi: 10.1007/s00038-020-01467-3.Epub 2020 Aug 29.
Calvin Q Pan12, Charles Rabinovich3, Vijay Gayam4, Milana Normatov3, Bazhena Fidman3, Dan Wang5
Author information
1Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, No. 8, Jingshun East Street, Chaoyang District, Beijing, 100015, China. Panc01@NYU.edu.
2Division of Gastroenterology and Hepatology, NYU Langone Health, New York University School of Medicine, 132-21 Forty-First Ave, Flushing, NY, 11355, USA. Panc01@NYU.edu.
3Quality Specialty Pharmacy, 1611 University Ave, Bronx, NY, USA.
4Interfaith Medical Center, SUNY Downstate University Hospital, Brooklyn, NY, USA.
5St. John's University, Jamaica, NY, USA.
Abstract
Objectives: Minority patients are under-screened for chronic hepatitis C (CHC) in the USA, and limited data exist for minority patients with advanced fibrosis.
Methods: In this cross-sectional study, CHC patients who were prescribed direct-acting antiviral agents were divided into White patients and minority patient groups. Primary measurements were the mean fibrosis scores and percentages of patients with stage III-IV fibrosis (late presenters) for the two groups.
Results: Among the 1421 patients with self-reported ethnicity, 697 were White patients, and 724 were minority patients (484 Hispanic, 175 Black, 65 Asians). Compared to the White, minority patients had significantly higher mean fibrosis score (p < 0.001) and a higher percentage of late presenters (p < 0.001). In subgroup analyses, the mean fibrosis scores for Hispanic, Black and Asian patients were 2.58 ± 1.38, 2.28 ± 1.41 and 2.28 ± 1.40, respectively.
Conclusions: Minority populations with CHC in the USA experience disparities in access to treatment in the early stages of liver fibrosis. Public health strategies are necessitated to address the inequality, as late presenters are at risk of hepatocellular carcinoma.