Hepatitis C and Racial Disparity in Liver Transplant Waitlist Additions

Author:

Wang Chloe Q.1,Buggs Jacentha1,Rogers Ebonie2,Boyd Ashley3,Kumar Ambuj4,Kemmer Nyingi5

Affiliation:

1. Department of Transplant Surgery, Tampa General Medical Group, Tampa, FL, USA

2. Office of Clinical Research, Tampa General Hospital, Tampa, FL, USA

3. Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA

4. Division of Evidence Based Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA

5. Department of Transplant Hepatology, Tampa General Medical Group, Tampa, FL, USA

Abstract

Background In 2014, direct-acting antivirals (DAAs) became available for hepatitis C virus (HCV) with successful results. Since their implementation, the rate of HCV waitlist (WL) for liver transplantation (LT) has decreased, but significant ethnic disparities exist. We hypothesized that the rate of decline for HCV WL for LT is different across the various racial groups. Methods We conducted a retrospective cohort study using Organ Procurement and Transplantation Network data reports of adult LT candidates from 2014 to 2018. Results Overall, there was a decline in HCV WL rates for all ethnic groups (Caucasians, African Americans [AA], and Hispanics). However, the WL rates were significantly higher in AA compared with Caucasians each year, and this trend was continuous across the 5-year period. There were no differences in WL rates between Caucasians and Hispanics. Discussion The results show that health care disparities related to HCV disproportionately affect AA. The factors associated with this disparity need to be explored further to develop mechanisms to address these differences. By understanding the HCV treatment disparities across racial groups, modifications to HCV treatment nationwide can be adopted. Additional emphasis should be placed on AA to help reduce their WL rate, as well as redistributing resources to promote health care equity.

Publisher

SAGE Publications

Subject

General Medicine

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