By Tracy Swan and Lei Chou
Background: In the United States, the highest all-cause mortality rates are found among African American men and women aged 25 to 64. This racial disparity is underscored by a disproportionate burden of viral hepatitis among African-Americans; hepatitis B virus (HBV) is 4.6 times more prevalent, and hepatitis C virus (HCV) is twice as prevalent among African-Americans than Caucasians.
Both incidence and prevalence of hepatocellular carcinoma (HCC) are greater among African Americans than Caucasians. African Americans with HCC are significantly younger at diagnosis than Caucasians, yet they are more likely to have advanced-stage HCC. Even when HCC is diagnosed at an early stage, African Americans are less likely to undergo surgery than Caucasians, and post-surgical survival is significantly poorer among African Americans than their Caucasian counterparts. As a consequence, mortality from viral hepatitis is almost two times greater among African Americans than Caucasians.
Despite viral hepatitis prevalence – and the high mortality rate from its complications – among African-Americans, they continue to be consistently underrepresented in clinical trials of new therapies for HBV and HCV. Research on barriers, and practical suggestions to surmount them are presented.