A descriptive study of racial inequalities in mortality from hepatocellular cancer before and after licensure of lifesaving drugs for hepatitis C virus in the United States

Racial Inequalities in Mortality from Coronavirus: The Tip of the Iceberg

“…Quantitatively, it is plausible that this large magnitude of increase of COVID-19 is an overestimate. Qualitatively, however, based on the existing totality of evidence, [4][5][6][7][8][9][10][11] the observation is real and poses major clinical and public health challenges. For example, for many decades, markedly reduced life expectancies of blacks compared with whites have been noted despite advances in preventive, diagnostic, and therapeutic options.…”

“…In addition, multiple factors have been identified and postulated to explain the observed persistent mortality disadvantages of blacks compared with whites. 5 Further, the availability of several life-saving, but prohibitively expensive to some, drugs [5][6][7][8] or a vaccine 9 in the United States has also led to marked increases in racial inequalities in mortality among blacks compared to whites.…”

“…7 Most recently, similar increases in racial inequalities in mortality from hepatocellular cancer occurred followed the licensure of life-saving, but prohibitively expensive for some, drugs for hepatitis C virus, which is a major risk factor. 8 Perhaps of greatest direct relevance to COVID-19 were the experiences before and after the development of the Salk vaccine for poliomyelitis. 9 In 1952, before the introduction of the vaccine, blacks experienced significantly lower rates of paralytic polio than whites.…”

The U. S. Department of Veterans Affairs (VA) as a model for stronger public health infrastructure to combat HCV and other infectious diseases and reduce disparities

“…Hepatitis C virus (HCV) is the leading cause for HCC in the U.S. In this descriptive study of racial inequalities in mortality from hepatocellular cancer (HCC) from 1979 to 2016, Levine et al reported that mortality from HCC is consistently higher among Blacks than Whites over time and that from 1979 to 1998 this difference in mortality was declining [1]. However, after life-saving but expensive interferon-based treatment for HCV became available in 1998, the disparity in mortality has been increasing [1].…”

“…In this descriptive study of racial inequalities in mortality from hepatocellular cancer (HCC) from 1979 to 2016, Levine et al reported that mortality from HCC is consistently higher among Blacks than Whites over time and that from 1979 to 1998 this difference in mortality was declining [1]. However, after life-saving but expensive interferon-based treatment for HCV became available in 1998, the disparity in mortality has been increasing [1]. Because data for this study end shortly after the emergence of the much more effective direct-acting antiviral (DAA) treatment for HCV, findings may not entirely reflect current HCC mortality rates and magnitude of disparity.…”