Racial and ethnic disparities in untreated patients with hepatitis C virus-related hepatocellular carcinoma but not in those with sustained virologic response
© 2024 John Wiley & Sons Ltd..
BACKGROUND: Racial and ethnic disparities exist for hepatitis C virus (HCV) treatment and hepatocellular carcinoma (HCC) survival.
AIM: To evaluate the impact of HCV treatment on such disparities.
METHODS: In a retrospective cohort study, we analysed 6069 patients with HCV-related HCC (54.2% Asian, 30.1% White, 8.5% Black, and 7.3% Hispanic) from centres in the United States and Asia.
RESULTS: The mean age was 61, 60, 59 and 68, respectively, for White, Black, Hispanic and Asian patients. Black patients were most likely to have Barcelona Clinic Liver Cancer stage D, vascular invasion and distant metastasis (23% vs. 5%-15%, 20% vs. 10%-17% and 10% vs. 5%-7%, respectively; all p < 0.0001). Treatment rate with direct-acting antiviral agents (DAA) was 35.9% for Asian, 34.9% for White, 30.3% for Hispanic (30.3%), and 18.7% for Black patients (p < 0.0001). Among those untreated or without sustained virologic response (SVR), 10-year survival rates were 35.4, 27.5, 19.3 and 14.0, respectively, for Asian, Hispanic, White and Black patients (p < 0.0001). There were no statistically significant differences among those with SVR (p = 0.44). On multivariable analysis adjusted for relevant confounders, there was no statistically significant association between survival and being Hispanic (aHR: 0.68, p = 0.26) or Black (aHR: 1.18, p = 0.60) versus White. There was a significant association between being Asian American and survival (aHR: 0.24, p = 0.001; non-U.S. Asian: aHR: 0.66, p = 0.05), and for SVR (aHR: 0.30, p < 0.0001).
CONCLUSION: DAA treatment rates were suboptimal. Racial and ethnic disparities resolved with HCV cure. Early diagnosis and improved access to HCV treatment is needed for all patients with HCV infection.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:59 |
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| Enthalten in: |
Alimentary pharmacology & therapeutics - 59(2024), 6 vom: 03. Feb., Seite 742-751 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Park, Jung Eun [VerfasserIn] |
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| Links: |
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| Themen: |
Antiviral Agents |
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| Anmerkungen: |
Date Completed 26.02.2024 Date Revised 26.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/apt.17863 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366638912 |
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| 100 | 1 | |a Park, Jung Eun |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Racial and ethnic disparities in untreated patients with hepatitis C virus-related hepatocellular carcinoma but not in those with sustained virologic response |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 26.02.2024 | ||
| 500 | |a Date Revised 26.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: Racial and ethnic disparities exist for hepatitis C virus (HCV) treatment and hepatocellular carcinoma (HCC) survival | ||
| 520 | |a AIM: To evaluate the impact of HCV treatment on such disparities | ||
| 520 | |a METHODS: In a retrospective cohort study, we analysed 6069 patients with HCV-related HCC (54.2% Asian, 30.1% White, 8.5% Black, and 7.3% Hispanic) from centres in the United States and Asia | ||
| 520 | |a RESULTS: The mean age was 61, 60, 59 and 68, respectively, for White, Black, Hispanic and Asian patients. Black patients were most likely to have Barcelona Clinic Liver Cancer stage D, vascular invasion and distant metastasis (23% vs. 5%-15%, 20% vs. 10%-17% and 10% vs. 5%-7%, respectively; all p < 0.0001). Treatment rate with direct-acting antiviral agents (DAA) was 35.9% for Asian, 34.9% for White, 30.3% for Hispanic (30.3%), and 18.7% for Black patients (p < 0.0001). Among those untreated or without sustained virologic response (SVR), 10-year survival rates were 35.4, 27.5, 19.3 and 14.0, respectively, for Asian, Hispanic, White and Black patients (p < 0.0001). There were no statistically significant differences among those with SVR (p = 0.44). On multivariable analysis adjusted for relevant confounders, there was no statistically significant association between survival and being Hispanic (aHR: 0.68, p = 0.26) or Black (aHR: 1.18, p = 0.60) versus White. There was a significant association between being Asian American and survival (aHR: 0.24, p = 0.001; non-U.S. Asian: aHR: 0.66, p = 0.05), and for SVR (aHR: 0.30, p < 0.0001) | ||
| 520 | |a CONCLUSION: DAA treatment rates were suboptimal. Racial and ethnic disparities resolved with HCV cure. Early diagnosis and improved access to HCV treatment is needed for all patients with HCV infection | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Hepatiis C | |
| 650 | 4 | |a hepatocellular carcinoma | |
| 650 | 4 | |a racial/ethnic disparity | |
| 650 | 7 | |a Antiviral Agents |2 NLM | |
| 700 | 1 | |a Nguyen, Vy H |e verfasserin |4 aut | |
| 700 | 1 | |a Tsai, Pei-Chien |e verfasserin |4 aut | |
| 700 | 1 | |a Toyoda, Hidenori |e verfasserin |4 aut | |
| 700 | 1 | |a Leong, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Guy, Jennifer E |e verfasserin |4 aut | |
| 700 | 1 | |a Yeh, Ming-Lun |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Chung-Feng |e verfasserin |4 aut | |
| 700 | 1 | |a Yasuda, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Abe, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Hsu, Yao-Chun |e verfasserin |4 aut | |
| 700 | 1 | |a Tseng, Cheng-Hao |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Joanne |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Yao-Li |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Ping-Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Jun, Dae Won |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshimaru, Yoko |e verfasserin |4 aut | |
| 700 | 1 | |a Ogawa, Eiichi |e verfasserin |4 aut | |
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| 700 | 1 | |a Enomoto, Masaru |e verfasserin |4 aut | |
| 700 | 1 | |a Tamori, Akihiro |e verfasserin |4 aut | |
| 700 | 1 | |a Uojima, Haruki |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Xiao Zhong |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Qiang |e verfasserin |4 aut | |
| 700 | 1 | |a Takahashi, Hirokazu |e verfasserin |4 aut | |
| 700 | 1 | |a Eguchi, Yuichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Inoue, Kaori |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Daniel Q |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Wen Jing |e verfasserin |4 aut | |
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| 700 | 1 | |a Dai, Chia-Yen |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Jee-Fu |e verfasserin |4 aut | |
| 700 | 1 | |a Barnett, Scott |e verfasserin |4 aut | |
| 700 | 1 | |a Maeda, Mayumi |e verfasserin |4 aut | |
| 700 | 1 | |a Cheung, Ramsey |e verfasserin |4 aut | |
| 700 | 1 | |a Landis, Charles |e verfasserin |4 aut | |
| 700 | 1 | |a Tanaka, Yasuhito |e verfasserin |4 aut | |
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