Racial and ethnic disparities in untreated patients with hepatitis C virus-related hepatocellular carcinoma but not in those with sustained virologic response

Jung Eun Park, Vy H. Nguyen, Pei Chien Tsai, Hidenori Toyoda, Jennifer Leong, Jennifer E. Guy, Ming Lun Yeh, Chung Feng Huang, Satoshi Yasuda, Hiroshi Abe, Yao Chun Hsu, Cheng Hao Tseng, Joanne Liu, Yao Li Chen, Ping Yi Lin, Dae Won Jun, Yoko Yoshimaru, Eiichi Ogawa, Masatoshi Ishigami, Masaru EnomotoAkihiro Tamori, Haruki Uojima, Xiao Zhong Wang, Qiang Xu, Hirokazu Takahashi, Yuichiro Eguchi, Kaori Inoue, Daniel Q. Huang, Wen Jing Zhao, Wan Long Chuang, Chia Yen Dai, Jee Fu Huang, Scott Barnett, Mayumi Maeda, Ramsey Cheung, Charles Landis, Yasuhito Tanaka, Lewis R. Roberts, Myron E. Schwartz, Takashi Kumada, Ming Lung Yu, Mindie H. Nguyen

Research output: Contribution to journalArticlepeer-review


Background: Racial and ethnic disparities exist for hepatitis C virus (HCV) treatment and hepatocellular carcinoma (HCC) survival. Aim: To evaluate the impact of HCV treatment on such disparities. Methods: In a retrospective cohort study, we analysed 6069 patients with HCV-related HCC (54.2% Asian, 30.1% White, 8.5% Black, and 7.3% Hispanic) from centres in the United States and Asia. Results: The mean age was 61, 60, 59 and 68, respectively, for White, Black, Hispanic and Asian patients. Black patients were most likely to have Barcelona Clinic Liver Cancer stage D, vascular invasion and distant metastasis (23% vs. 5%–15%, 20% vs. 10%–17% and 10% vs. 5%–7%, respectively; all p < 0.0001). Treatment rate with direct-acting antiviral agents (DAA) was 35.9% for Asian, 34.9% for White, 30.3% for Hispanic (30.3%), and 18.7% for Black patients (p < 0.0001). Among those untreated or without sustained virologic response (SVR), 10-year survival rates were 35.4, 27.5, 19.3 and 14.0, respectively, for Asian, Hispanic, White and Black patients (p < 0.0001). There were no statistically significant differences among those with SVR (p = 0.44). On multivariable analysis adjusted for relevant confounders, there was no statistically significant association between survival and being Hispanic (aHR: 0.68, p = 0.26) or Black (aHR: 1.18, p = 0.60) versus White. There was a significant association between being Asian American and survival (aHR: 0.24, p = 0.001; non-U.S. Asian: aHR: 0.66, p = 0.05), and for SVR (aHR: 0.30, p < 0.0001). Conclusion: DAA treatment rates were suboptimal. Racial and ethnic disparities resolved with HCV cure. Early diagnosis and improved access to HCV treatment is needed for all patients with HCV infection.

Original languageEnglish
Pages (from-to)742-751
Number of pages10
JournalAlimentary Pharmacology and Therapeutics
Issue number6
StatePublished - Mar 2024
Externally publishedYes


  • Hepatiis C
  • hepatocellular carcinoma
  • racial/ethnic disparity


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