P4647 - Differences in the Prevalence and Mortality of Chronic Hepatitis C Infection by Race and Ethnicity Among Inpatients with Coronary Artery Disease

Kimberly Ho, MD¹, Stacy Zhang, PhD^2
1Brown University / Rhode Island Hospital, Providence, RI; ²NYU Grossman Long Island School of Medicine, Mineola, NY

Introduction: Since 2010, there has been an increasing incidence of acute hepatitis C virus (HCV) cases every year. In 2021, it was estimated that there were roughly 70,000 acute HCV cases and approximately 15,000 HCV-attributable deaths, which incurs more than $15 billion annually.
Chronic hepatitis C can complicate the treatment of coronary artery disease (CAD), especially among racial and ethnic minority patients. This study explores racial and ethnic differences in the prevalence of hepatitis C and inpatient mortality among patients admitted to the hospital primarily for a CAD event in the United States.

Methods: An observational analysis was conducted using data from the 2016 to 2019 National Inpatient Sample. We performed weighted logistic regressions to analyze the relationship between race and ethnicity (non-Hispanic (NH) White, NH Black, Hispanic and other races) for the prevalence of hepatitis C and inpatient mortality, adjusting for patient sociodemographic characteristics and comorbidities.

Results: Out of the total sample of 1,365,067 patients with CAD, 5,310 patients (0.39%) had chronic HCV infection. Of these patients, 54.56% were NH White, 29.98% were NH Black, 9.68% were Hispanic, and 5.78% were Asian, Pacific Islanders, Native Americans, or others. Among them, 254 (0.43%) patients died in the hospital. The prevalence of HCV infection among CAD patients was significantly higher among NH Black and Hispanic patients than among NH White patients.
When adjusting for confounding variables, NH Black patients were found to have a significantly higher HCV prevalence than NH White patients (OR = 1.88, 95% CI = 1.75-2.02). Hispanic and other racial groups were found to have a lower HCV prevalence than NH White patients.
However, NH Black patients did not show a significantly increased in-hospital mortality associated with HCV compared to NH White patients (OR = 1.02, 95% CI = 0.76-1.37). After adjusting for confounding variables, Hispanic patients continued to have a significantly higher in-hospital mortality than NH White patients (OR = 1.64, 95% CI = 1.10-2.45).

Discussion: We found significant racial and ethnic differences in the prevalence and mortality among patients with underlying chronic hepatitis C admitted primarily for CAD events in the US. This disparity may be due to lower rates of HCV treatment, higher severity and prevalence of underlying comorbidities, poorer healthcare access and insurance coverage, and a higher rate of alcohol use and cirrhosis in minority populations.


Disclosures:


Kimberly Ho, MD¹, Stacy Zhang, PhD². P4647 - Differences in the Prevalence and Mortality of Chronic Hepatitis C Infection by Race and Ethnicity Among Inpatients with Coronary Artery Disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.