Aim: Examine racial and ethnic inequities in hepatitis C and B virus (HCV and HBV) screening across high-risk populations.
Subject And Methods: Chronic HCV and HBV infections can lead to cirrhosis, hepatocellular carcinoma (HCC), and death. Despite universal screening recommendations, < 50% of US adults are tested for these viruses. Populations with lower socio-economic status experience higher rates of viral-related cirrhosis and HCC, which may be reduced through screening and treatment. This study analyzed data from 91,875 patients (2019-2021) at the Health Choice Network, a federally qualified health center in Florida. Logistic regression assessed the determinants of HCV and HBV screening, considering factors such as age, sex, language, and race/ethnicity.
Results: The study population was predominantly female, Hispanic, uninsured, and living below the federal poverty line. Overall, 61.7% had HCV screening, and 43.7% had HBV screening. Haitian Creole-speaking patients (aOR 1.67; 95% CI, 1.50-1.85), Asian (aOR 1.41; 95% CI, 1.26-1.58), Spanish-speaking Hispanic (aOR 1.38; 95% CI, 1.32-1.44), and English-speaking Hispanic patients (aOR 1.12; 95% CI, 1.07-1.18) had higher odds of HCV screening, compared to NH-Whites. Similarly, Haitian Creole-speaking (aOR 1.91; 95% CI, 1.73-2.12), Asian (aOR 1.50; 95% CI, 1.33-1.68), and Spanish-speaking Hispanic patients (aOR 1.23; 95% CI, 1.17-1.29) had higher odds of HBV screening.
Conclusion: For an underserved population context, screening rates were above average, with higher prevalence among historically disadvantaged populations. However, rates remained suboptimal, particularly among NH-Whites, who account for the largest number of HCV-related liver cancers, often linked to injection drug use. Increasing screening, especially among NH-Whites and English-speaking Hispanics for HCV, is crucial for early diagnosis, treatment, and reducing severe liver disease risk, including cirrhosis and HCC.
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