Original Article

Does the Race or Gender of Hepatitis C Infected Patients Influence Physicians’ Assessment of Hepatitis A and Hepatitis B Serologic Status

Authors: David B. Ramsay, MD, Mark Friedman, MD, Marie L. Borum, MD, EdD, MPH

Abstract

Background: HCV infection with concurrent or superinfection with HAV or HBV has the potential to worsen the liver status of HCV-infected individuals. This study evaluates if patients’ race or gender influenced whether HAV or HBV serologic status was determined for the purpose of providing immunization.


Methods: Medical records of consecutive African-American and white patients referred for management of HCV were evaluated to determine whether the referring physicians had obtained HAV and HBV serology.


Results: Race and gender analysis revealed a statistically significant difference (P < 0.0001) in HAV testing of African-American and white patients, a statistically significant difference in HAV (P < 0.0001) and HBV (P < 0.0001) testing of African-American and white men, and a statistically significant difference (P = 0.0026) in HBV testing of African-American and white women.


Conclusion: HCV-infected individuals were inconsistently tested for HAV and HBV. Patients’ race, but not gender, had a significant impact upon whether HCV-infected individuals were tested for HAV and HBV.


Key Points


* Hepatitis C causes significant morbidity and mortality, particularly in the African-American community.


* Concurrent or superinfection with hepatitis A (HAV) or hepatitis B (HBV) has the potential to worsen the liver status of HCV-infected individuals.


* There is a significant difference in the rate which HCV positive African-American and white men were tested for immunity from HAV and HBV.


* There is a significant difference in the rate of testing for HBV between HCV positive African-American and white women.


* The additional testing and subsequent immunization could have a significant impact on the morbidity and mortality of HCV-infected individuals, particularly those at highest risk for superinfection.

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