Health Disparities in Achieving Sustained Virologic Response Among Patients With Chronic Hepatitis C: A Retrospective...

Introduction Hepatitis C virus (HCV) infection remains a significant public health concern, though direct-acting antivirals (DAAs) have achieved a cure. Sustained virologic response (SVR) at 12 weeks is the most common metric used to assess the efficacy of antiviral therapy in eliminating HCV from the body. Varying treatment outcomes have been reported across different demographic and socioeconomic groups. Understanding the existence and implications of health disparities in HCV treatment is crucial for designing equitable healthcare interventions. In this study, we aimed to describe the potential health disparities related to achieving SVR. Methods A retrospective chart review was conducted of adult (19+ years) patients treated for HCV in Gastroenterology and Infectious Diseases clinics at a single institution from 2018 to 2022. Log binomial regression was used to estimate the adjusted likelihood of achieving SVR; covariates included age, sex, race, marital status, median household income by zip code, presence of cirrhosis on imaging, and the DAA used for treatment. Results Among the study population, 285 (79%) patients achieved SVR. Although there were no statistically significant differences in the likelihood of achieving SVR observed across any covariate, several factors approached significance. Asian patients were less likely to achieve SVR compared to Caucasian patients, with a relative risk (RR) of 0.92 (95% confidence interval (CI), 0.80-1.05). Cirrhotic patients were more likely to achieve SVR compared to non-cirrhotic patients with a RR of 1.15 (0.99-1.32). Married patients were more likely to achieve SVR compared to single or widowed patients, with a RR of 1.12 (0.98-1.27). Conclusion We observed a higher likelihood of achieving SVR in Caucasian patients, cirrhotic patients, and married patients, although none of the differences achieved statistical significance. Further studies with larger sample sizes are needed to elucidate the disparities and better guide targeted measures to improve them.