Hep C risk varies among Hispanics

Overall rates of hepatitis C (HCV) among Hispanics in the United States are similar to rates in whites, but there are huge differences among Hispanic subgroups, study findings suggest.

Testing and treatment should be targeted towards Hispanic groups at highest risk, according to Mark Kuniholm, PhD, of Albert Einstein College of Medicine in New York City, and colleagues.

“It’s not appropriate to lump all U.S. Hispanics into a single, broad at-risk group,” Kuniholm said in a press release.

Prevalence rates range from 0.4% in Hispanic men of South American or Cuban background to 11.6% in those of Puerto Rican background, findings from the National Health and Nutrition Examination Survey (NHANES) 2007-2010 and the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) 2008-2011 indicate.

The researchers examined data from the two studies to better understand HCV antibody prevalence and correlates of HCV infection among U.S. Hispanic adults. After adjusting for differences in sampled age groups and for missing HCV antibody and RNA data, the study population included 3,210 participants from NHANES and 11,964 from HCHS/SOL.

In NHANES, 63% of participants were of Mexican background, while HCHS/SOL participants had multiple backgrounds — 39% Mexican, 16% Cuban, 15% Puerto Rican, 9.0% Dominican, 11% Central American, 7.0% South American, and 3.0% from mixed or other backgrounds.

Overall, age-standardized prevalence of HCV antibodies, the primary endpoint of the analysis, was similar in the two studies (1.5% in NHANES and 2.0% in HCHS/SOL). Disease prevalence was slightly higher among Hispanics when compared with whites between 1998 and 2008 (1.2% for NHANES and 1.5% for the HCHS/SOL).

But HCV risk varied substantially in HCHS/SOL depending on background, the researchers found. Compared with those of Mexican descent:

• The odds ratios for Puerto Rican men and women were 4.92 and 2.90, respectively, and were significant (P<0.01 and P=0.05)
• The ORs for South American men and women were 0.04 and 0.07, respectively (P<0.01 and P=0.02)
• Most other groups had ORs that suggested a lower risk, but they did not reach statistical significance.

Overall, HCV prevalence was higher among vs. women for NHANES (2.1% vs. 0.9%; P<0.01) and for HCHS/SOL (2.9% vs. 1.2%; P<.01), respectively.

Although men aged 40 to 69 years had the highest prevalence for HCV in both cohorts, the prevalence was significantly higher among men aged between 50 and 59 years in the HCHS/SOL vs. NHANES cohort (7.3% vs. 2.1%; P<0.05).

When the researchers compared recruitment sites, they found that adults from the Bronx had a significantly higher HCV prevalence (4.5%) when compared with those residing in San Diego (1.7%), Chicago (1.2%) and Miami (0.8%; P<0.01).

“These data signify that the scale of the HCV epidemic varies between Hispanic/Latino background groups,” the researchers wrote. “This information will be useful to those who direct public health resources for HCV treatment and prevention. Clinicians who serve Hispanic/ Latino communities may also benefit from this information because it highlights specific […] groups that may benefit from increased levels of HCV testing and treatment.”

Study limitations included lower participation rates in HCHS/SOL than NHANES, and the researchers cautioned the HCHS/SOL sample was not representative of all U.S. Hispanic/Latinos.