Importance In the US, the prevalence of hepatitis C virus (HCV) is 1.8% among people who are Black and 0.8% among people who are not Black. Mortality rates due to HCV are 5.01/100 000 among people who are Black and 2.98/100 000 among people who are White.
Hepatitis C virus (HCV) is the most common chronic bloodborne infection in the US and a leading cause of mortality from infectious disease, primarily through progression to cirrhosis, liver failure, and hepatocellular carcinoma (HCC).1-3 From 2013 to 2016, approximately 4.1 million people in the US had a positive HCV antibody test result, indicating past or current HCV infection, of whom approximately 2.4 million had current HCV infection with HCV RNA detected in their blood.1 Among approximately 29 065 800 Black individuals in the US between 2013 and 2016, the prevalence of HCV infection was 1.8% compared with 0.8% among approximately 215 615 900 individuals of other races and ethnicities combined (prevalence ratio [PR], 2.2) (Table 1).4 Black individuals comprise 23% of all HCV-infected individuals in the US, but represent approximately 12% of the population.4 Among US residents in 2021, those who were non-Hispanic Black had an HCV mortality rate of 5.01/100 000 compared with 9.99/100 000 for American Indian/Alaska Native individuals, 1.32/100 000 for Asian/Pacific Islander individuals, 3.67/100 000 for Hispanic individuals, and 2.98/100 000 for non-Hispanic White individuals (Table 2).3 Of the approximately 13 895 HCV-related deaths in 2021, an estimated 279 were among American Indian/Alaska Native people, 293 among Asian/Pacific Islander people, 2442 among Black people, and 1901 among Hispanic people.
Because of the high prevalence and absolute number of annual HCV-related deaths in Black populations relative to other racial and ethnic minority groups, this review summarizes evidence regarding Black race and inequities in outcomes of HCV infection.
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