Hepatitis C and Hispanic Americans

Race and ethnicity have many definitions. People can also self-identify in multiple ways at once. This can make it challenging to see how different groups are impacted by a health condition. But when it comes to hepatitis C virus (HCV), there are a few trends. Specifically, Hispanic Americans have different experiences than their non-Hispanic peers.^1,2

The term Hispanic refers to several different groups. These include people from Puerto Rico, Cuba, Mexico, and many other countries. Nearly 20 percent of people in the United States are Hispanic. They make up 1 of the fastest-growing minority populations in the United States.^1,2

Experience with HCV

There are differences in the way HCV impacts Hispanic Americans. For example, they are more likely to:^1,3,4

• Be infected at a younger age
• Be diagnosed later
• Also have HIV at the same time (co-infection)

Compared to their non-Hispanic peers, Hispanics with HCV – especially women – have:^1,3,4

• More inflammation in the liver
• Worse liver function tests
• Faster rates of fibrosis (reversible liver damage)
• Higher rates of cirrhosis (permanent liver scarring)

Differences in HCV outcomes

In recent years, the proportion of Hispanics dying from HCV and other hepatitis viruses has been higher than other groups. This group was 70 percent more likely to die from a hepatitis virus than their non-Hispanic white peers.⁵

When it comes to HCV specifically, the same trends occur. For example, in 2018, Hispanics were 40 percent more likely to die from HCV than non-Hispanic white people. In all, fewer Hispanics are affected by HCV, but the number having serious outcomes is high.⁵

Why does HCV affect Hispanic Americans differently?

Experts do not know why these differences occur in Hispanics. Some have suggested the differences are related to other medical conditions, such as insulin resistance or alcohol use. Fatty changes in the liver may also be at play. Much more research is needed to understand what is going on.^1,3,4,6

But 1 idea has come up more often in recent years. This is related to social determinants of health.

What are social determinants of health?

Social determinants of health refer to our environment. They are the factors we deal with daily that can affect our health, such as:⁷

• Access to education
• Access to healthcare
• Stable finances
• Safe housing

When people have fewer resources, it may be harder for them to take care of themselves well. Without access to transportation, it can be hard to go to the doctor. Without access to healthy foods, eating well can be a struggle.

All of these can lead to differences in how healthy people are. Many minority groups have trouble getting past these factors. This may be a big reason why the effects of certain health conditions are worse in these groups. For example, if a person does not have access to healthcare, they might not be tested for HCV. Even if they are diagnosed, they may not be able to see a doctor or pay for treatment. All of these could play a role in why Hispanics are diagnosed later and have higher rates of fibrosis or cirrhosis.^1-4

There are many factors involved when it comes to HCV across different groups. But genetic differences and social determinants of health may play a big role.