Background In the United States, hepatitis C virus (HCV) diagnoses among reproductive-aged women are increasing amidst the ongoing opioid and drug overdose epidemic. While previous studies document racial and ethnic disparities in HCV testing and treatment in largely male populations, to our knowledge no national studies analyze these outcomes in reproductive-aged women with opioid use disorder (OUD). Methods We analyzed data from a cohort of reproductive-aged women (aged 15–44 years) with diagnosed OUD captured in the TriNetX Research Network, a network of electronic health records from across the United States. Using a log-binomial model, we assessed differences in achieving HCV cascade of care stages (HCV antibody testing, HCV infection [positive HCV RNA test result], linkage to care, and HCV treatment) by race and ethnicity. Results From 2014 to 2022, 44.6% of the cohort were tested for HCV antibody. Asian and black/African American individuals had a lower probability of having an HCV antibody test than white individuals (risk ratio, 0.77 [95% confidence interval, .62–.96] and 0.76 [.63–.92], respectively). Among those with HCV infection, only 9.1% were treated with direct-acting antivirals. Hispanic/Latinx individuals had a higher probability of treatment than non-Hispanic/Latinx individuals (risk ratio, 1.63 [95% confidence interval, 1.01–2.61]). Conclusions Few reproductive-aged women with OUD are tested or treated for HCV. Disparities by race and ethnicity in HCV testing further exacerbate the risk of perinatal transmission and disease progression among minoritized communities. Interventions are needed to improve overall rates of and equity in HCV screening and treatment for reproductive-aged women.

中文翻译：

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患有阿片类药物使用障碍的育龄妇女丙型肝炎护理的种族和民族差异


背景 在美国，在持续的阿片类药物和药物过量流行中，育龄妇女的丙型肝炎病毒 （HCV） 诊断正在增加。虽然以前的研究记录了以男性为主的 HCV 检测和治疗方面的种族和民族差异，但据我们所知，没有全国性研究分析患有阿片类药物使用障碍 （OUD） 的育龄妇女的这些结果。方法 我们分析了在 TriNetX 研究网络（来自美国各地的电子健康记录网络）中捕获的诊断为 OUD 的育龄妇女队列（15-44 岁）的数据。使用对数二项式模型，我们评估了种族和民族在实现 HCV 级联护理阶段（HCV 抗体检测、HCV 感染 [阳性 HCV RNA 检测结果]、与护理的联系和 HCV 治疗）方面的差异。结果从 2014 年到 2022 年，44.6% 的队列接受了 HCV 抗体检测。亚裔和黑人/非裔美国人进行 HCV 抗体检测的可能性低于白人个体（风险比分别为 0.77 [95% 置信区间，.62-.96] 和 0.76 [.63-.92]）。在 HCV 感染者中，只有 9.1% 接受了直接抗病毒药物治疗。西班牙裔/拉丁裔个体接受治疗的可能性高于非西班牙裔/拉丁裔个体 （风险比，1.63 [95% 置信区间，1.01-2.61]）。结论 很少有患有 OUD 的育龄妇女接受 HCV 检测或治疗。HCV 检测中的种族和民族差异进一步加剧了少数族裔社区围产期传播和疾病进展的风险。需要采取干预措施来提高育龄妇女 HCV 筛查和治疗的总体发生率和公平性。