What Black Americans Should Know About Hepatitis C Testing and Treatment
Key takeaways:
The hepatitis C virus is a viral infection that can lead to liver damage and cancer.
Black Americans are more likely to be affected by hepatitis C but less likely to receive treatment.
Everyone should get tested for hepatitis C. Hepatitis C is treatable and usually curable.
Hepatitis C is a liver infection caused by the hepatitis C virus. Over time, hepatitis C can lead to permanent liver scarring and damage. Some people even develop liver cancer.
The good news is there are effective treatments for hepatitis C that can cure the infection so people don’t develop liver disease. And the sooner you get tested and start treatment, the more likely your infection can be cured.
But not everyone has equitable access to these medications. This is particularly true for Black Americans, who are more likely to be affected by hepatitis C and less likely to receive treatment. Discrimination, cost, and other factors have created potential barriers to care.
And many people living with hepatitis C don’t know they have it, so they might not get care until it’s too late. Getting tested is the first step to finding out if you have the infection. And there are resources available to help get you started on treatment. Here’s what you need to know about hepatitis C testing and treatment.
How many Black Americans have hepatitis C?
About 700,000 Black Americans have hepatitis C. But we don’t know the exact number, because so many people don’t know they have hepatitis C.
What’s more concerning, Black Americans are twice as likely as any other racial or ethnic group to be affected by hepatitis C. And they’re also more likely to die from hepatitis C.
The CDC is working to reduce these health disparities by 2025. And so far, there’s been progress by:
Encouraging people to get tested, so they know if they have hepatitis C
Making sure people know they can get treatment for hepatitis C
Improving access to healthcare providers through telemedicine services
Creating educational materials and campaigns to educate Black Americans about hepatitis C
Should I be tested for hepatitis C?
The CDC recommends that every person age 18 and older gets tested for hepatitis C at least once in their lifetime. You should also get tested with each pregnancy.
Keep in mind: You may have hepatitis C and not even know it. About 40% of people with chronic hepatitis C are unaware of their infection. Knowing your hepatitis C status is important because treatments can cure hepatitis C and reduce the chance of developing chronic liver disease and liver cancer.
Don’t assume your annual blood work checked for hepatitis C. And remember, your liver blood tests can be completely normal even if you have hepatitis C.
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Finding out whether you have hepatitis C is the first step in making sure you stay healthy.
How can I be tested for hepatitis C?
A simple blood test can show if you have hepatitis C. Soon, at-home tests will be available. But for now, you can talk to your healthcare provider about getting a hepatitis C antibody test. You can also get screened for hepatitis C using telemedicine providers.
Is there treatment for hepatitis C?
There is treatment for hepatitis C. New medications — direct-acting antiviral therapies (DAATs) — cure hepatitis C in over 95% of people. The DAATs healthcare providers most commonly prescribe are:
For initial treatment, you take DAATs every day for about 8 to 12 weeks. The medications come in pill form, and you only have to take them once a day. And most people report having very few side effects.
Why were old hepatitis C treatments less effective in Black Americans?
It’s true that in the past, Black Americans didn’t respond as well to medications for hepatitis C.
Studies show that Black Americans are more likely to be infected with genotype 1. But other racial and ethnic groups were more likely to be infected with genotypes 2 and 3. Older treatments for hepatitis C were less effective for treating genotype 1 infection. But that wasn’t immediately clear because Black Americans were underrepresented in the clinical trials that tested these medications.
That’s not the case with new DAATs. Studies show that DAATs can effectively treat all hepatitis C genotypes. But keep in mind that DAATs work better when you take them early. DAAT therapy is less likely to cure people who’ve already developed liver damage from hepatitis C. That’s why it’s important to get tested and start treatment as soon as possible.
Why are Black Americans less likely to receive treatment for hepatitis C?
Even though hepatitis C disproportionately affects Black Americans, they’re still less likely to get treatment for hepatitis C. Studies show there are racial disparities in the treatment of hepatitis C and suggest racial discrimination may play a role.
In the past, Black Americans were more likely to be considered ineligible for hepatitis C treatment than other racial and ethnic groups. This was in part because older medications weren’t recommended for people with certain medical conditions, like diabetes or kidney disease. This is no longer an issue, since experts recommend DAATs for everyone who has hepatitis C, regardless of their medical history.
But Black Americans face other barriers for treatment. DAATs are expensive, which limits many people’s ability to access these lifesaving medications. It can also be hard to find a healthcare provider to follow your progress if you don’t have insurance.
Some resources that can help include:
If you have Medicare, you may consider getting additional coverage to help cover the costs of DAAT therapy. You can contact the State Health Insurance Assistance Program (SHIP) to talk for free with an unbiased benefits counselor about your Medicare choices.
The bottom line
Hepatitis C is more likely to affect Black Americans than any other group in the U.S. Hepatitis C can lead to liver failure, cancer, and death. But new medications can cure hepatitis C. And unlike older medications, studies show they work well in all racial groups.
The first step to staying healthy is getting a hepatitis C test. Talk to your healthcare provider about getting tested — everyone should be tested for hepatitis C at least once in their lifetime.
Why trust our experts?
References
American Association for the Study of Liver Diseases, et al. (2019). When and in whom to initiate HCV therapy.
American Association for the Study of Liver Diseases, et al. (2021). Simplified HCV treatment* for treatment-naive adults without cirrhosis.
Bates, C. (2013). Addressing hepatitis C disparities in the African American community. HIV.gov.
Bradley, H., et al. (2020). Hepatitis C virus prevalence in 50 U.S. states and D.C. by sex, birth cohort, and race: 2013-2016. Hepatology Communications.
Centers for Disease Control and Prevention. (2020). National progress report 2025 goal: Reduce reported rate* of hepatitis C-related deaths among non-Hispanic Black persons by ≥30%.
Centers for Disease Control and Prevention. (2021). National African American hepatitis action day.
Falade-Nwulia, O., et al. (2017). Oral direct-acting agent therapy for hepatitis C virus infection: A systematic review. Annals of Internal Medicine.
Schillie, S., et al. (2020). CDC recommendations for hepatitis C screening among adults — United States, 2020. Morbidity and Mortality Weekly Report.
Sims, O. T., et al. (2017). Racial disparities in hepatitis C treatment eligibility. Annals of Hepatology.
State Health Insurance Assistance Program. (n.d.). SHIP.
U.S. Department of Health and Human Services. (2020). Hepatitis C basic information.
World Health Organization. (2021). WHO releases first guidelines on hepatitis C virus self-testing.
