{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T22:34:05Z","timestamp":1791326045921,"version":"4.3.1"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005292","name":"Brigham and Women's Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005292","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Hepatitis C virus (HCV) disproportionately affects racial minorities and socially disadvantaged groups in the United States. Despite highly effective direct-acting antiviral (DAA) therapies, treatment disparities persist.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort study using electronic medical record data from both inpatient and outpatient settings in an urban academic medical center between 1 October 2018 and 1 October 2023. Multivariable logistic regression identified sociodemographic and clinical predictors of HCV treatment initiation, defined as a documented direct-acting antiviral prescription, among individuals with positive HCV RNA between 2018 and 2023.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 4345 individuals, 1150 (26.5%) were prescribed HCV treatment. Black individuals were less likely to be prescribed HCV treatment compared to White individuals (adjusted odds ratio [aOR], 0.68 [95% confidence interval {CI}, .53\u2013.88]). Individuals experiencing homelessness (aOR, 0.57 [95% CI, .46\u2013.69]) and those with Medicaid (aOR, 0.82 [95% CI, .68\u2013.98]) or no insurance (aOR, 0.49 [95% CI, .37\u2013.65]) were also less likely to be prescribed HCV treatment. Individuals with mental health diagnoses (aOR, 1.34 [95% CI, 1.11\u20131.61]) were more likely to receive HCV treatment. Untreated individuals had a higher percentage of inpatient (12.3%) and emergency department visits (17.7%) than those who received treatment (3.4% and 4.8%, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Significant disparities in HCV treatment initiation were observed, with lower rates among Black individuals, those experiencing homelessness, and individuals with Medicaid or no insurance. These inequities perpetuate a disproportionate burden of liver disease and preventable mortality in already marginalized populations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf312","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T14:10:53Z","timestamp":1749823853000},"source":"Crossref","is-referenced-by-count":4,"title":["Racial and Sociodemographic Disparities in Hepatitis C Treatment at an Urban Academic Medical Center, 2018\u20132023"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0155-8132","authenticated-orcid":false,"given":"Ahmed D","family":"Elnaiem","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]},{"name":"Harvard T. H. Chan School of Public Health , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand B","family":"Chukka","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia M","family":"So-Armah","sequence":"additional","affiliation":[{"name":"Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]},{"name":"Brookside Community Health Center; Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MaryCatherine E","family":"Arbour","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]},{"name":"Center on the Developing Child, Harvard University , Cambridge, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8775-3755","authenticated-orcid":false,"given":"Chuan-Chin","family":"Huang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-3326","authenticated-orcid":false,"given":"Daniel A","family":"Solomon","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E","family":"Malishchak","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6537-892X","authenticated-orcid":false,"given":"Chase G","family":"Yarbrough","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"key":"2025062505204928900_ofaf312-B1","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1001\/jama.2023.3942","article-title":"Former NIH director Francis S. Collins on the new White House Plan to Eliminate Hepatitis C","volume":"329","author":"Abbasi","year":"2023","journal-title":"JAMA"},{"key":"2025062505204928900_ofaf312-B2","doi-asserted-by":"crossref","first-page":"79","DOI":"10.14218\/JCTH.2017.00067","article-title":"Hepatitis C virus and hepatocellular carcinoma: a narrative review","volume":"6","author":"Axley","year":"2018","journal-title":"J Clin Transl Hepatol"},{"key":"2025062505204928900_ofaf312-B3","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.gtc.2015.07.003","article-title":"Natural history of hepatitis C","volume":"44","author":"Lingala","year":"2015","journal-title":"Gastroenterol Clin"},{"key":"2025062505204928900_ofaf312-B4","first-page":"viii","volume-title":"Hepatitis and STIs programmes (HHS), health product policy and standards (HPS). Global hepatitis report 2024: action for access in low- and middle-income countries","author":"World Health Organization (WHO)","year":"2024","edition":"1st ed"},{"key":"2025062505204928900_ofaf312-B5","first-page":"A98","article-title":"Understanding barriers and enablers to hepatitis C treatment initiation: a systematic review of qualitative studies","volume":"73","author":"Bryce","year":"2024","journal-title":"Gut"},{"key":"2025062505204928900_ofaf312-B6","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1056\/NEJMoa1702417","article-title":"Glecaprevir-pibrentasvir for 8 or 12 weeks in HCV genotype 1 or 3 infection","volume":"378","author":"Zeuzem","year":"2018","journal-title":"N Engl J Med"},{"key":"2025062505204928900_ofaf312-B7","doi-asserted-by":"crossref","first-page":"2599","DOI":"10.1056\/NEJMoa1512610","article-title":"Sofosbuvir and velpatasvir for HCV genotype 1, 2, 4, 5, and 6 infection","volume":"373","author":"Feld Jordan","year":"2015","journal-title":"N Engl 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