Social Determinants of Hepatitis C Virus Infection in the United States, 2016–2021
Publication: Population Health Management
Volume 27, Issue Number 4
Abstract
This cross-sectional study assessed hepatitis C virus (HCV) antibody and RNA test results performed from 2016 to 2021 at a large US clinical reference laboratory. When individual patient factors (ie, income, education, and race/ethnicity) were not available, estimates from the US Census were linked to the residential zip code. The final analytic cohort comprised 19,543,908 individuals with 23,233,827 HCV antibody and RNA test results. An analysis of progressively increasing poverty quintiles demonstrated an increasing trend in both HCV antibody positivity (from 2.6% in the lowest quintile to 6.9% in the highest, P < 0.001 for trend) and HCV RNA positivity (from 1.0% to 3.6%, P < 0.001 for trend). Increasing levels of education were associated with a decreasing trend in both HCV antibody positivity (from 8.4% in the least educated quintile to 3.0% in the most, P < 0.001 for trend) and HCV RNA positivity (from 4.7% to 1.2%, P < 0.001 for trend). Persistent differences in positivity rates by these social determinants were observed over time. HCV antibody and RNA positivity rates were nearly identical in predominantly Black non-Hispanic, Hispanic, and White non-Hispanic zip codes. However, after adjustment for all other factors in the study, residents of predominantly Black non-Hispanic and Hispanic zip codes were significantly less likely to test positive for HCV RNA (adjusted odds ratios [AOR]: 0.51, 95% confidence interval [CI]: 0.51–0.52; AOR: 0.46, 95% CI: 0.46–0.46, respectively). These findings may benefit targeted intervention initiatives by public health agencies.
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Information & Authors
Information
Published In

Population Health Management
Volume 27 • Issue Number 4 • August 2024
Pages: 284 - 290
PubMed: 39101828
Copyright
Copyright 2024, Mary Ann Liebert, Inc., publishers.
History
Published online: 16 August 2024
Published ahead of print: 5 August 2024
Published in print: August 2024
Topics
Data Sharing Statement
Requests for data to researchers should be addressed to the corresponding author.
Authors
Authors’ Contributions
J.K.N., W.A.M., and H.W.K. conceptualized and designed the study. J.K.N., A.P., and A.S. drafted the initial article. All authors critically reviewed and revised the article. All authors approved the final article as submitted and agree to be accountable for all aspects of the work.
Author Disclosure Statement
J.K.N., H.W.K., and W.A.M. are employed or contracted by Quest Diagnostics and own stock in Quest Diagnostics. A.P. and A.S. are employees of Quest Diagnostics.
Funding Information
No funding was received for this article.
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