Disparities in Awareness of Hepatitis C Virus Among US Adults: An Analysis of the 2019 Health Information National Trends Survey

Abstract

Background: The U.S. Preventive Services Task Force updated hepatitis C virus (HCV) screening 2020 guidelines to target adults aged 18 to 79 years: a major shift from the prior focus on high-risk populations ("baby boomers" aged ≥55 years as of 2019). To inform efforts to maximize HCV screening coverage, our objective was to identify demographic groups reporting a lack of HCV awareness, particularly by race/ethnicity and age, and sources of health information. Methods:We used nationally representative data of adults (≥18 years) included in the 2019 Health Information National Trends Survey (n = 5438). Awareness of HCV was defined using the following question: "Have you ever heard of the hepatitis C virus (also known as Hep C or HCV)?" We estimated frequencies by demographic groups and computed risk differences (RDs) with 95% confidence intervals (CIs) to compare lack of HCV awareness by age (<55 and ≥55 years) and race/ethnicity.Results: Overall, 17% of adults never heard of HCV. Younger adults (<55 years; 21%) were more likely to have never heard of HCV compared with older adults (≥55 years; 12%; χ 2 P < 0.001). This observation was consistent across most demographic characteristics including, racial/ ethnic categories, and residing in the Southern United States. More than one-third of adults with low English fluency had a lack of HCV awareness in both age groups (χ 2 P = 0.537). Non-Hispanic (NH) Asian (RD, 25%; 95% CI, 6.9%-43.3%) and Hispanic (RD, 10%; 95% CI, 0.01%-19.6%) adults younger than 55 years were significantly more likely to have never heard of HCV compared with their NH White counterparts after adjustment for sex, educational level, household income, English fluency, and having a regular provider. Adults younger than 55 years with a lack of HCV awareness commonly obtained their health information from the Internet across most sociodemographic characteristics.Conclusions: Hispanic and NH Asian young adults should be targeted for public health messaging regarding HCV screening, potentially through social media campaigns.

Public knowledge and attitudes toward liver diseases and liver cancer in the Brazilian population: a cross sectional study

“…This is important since inadequate knowledge about cirrhosis and HCC is considered a critical factor in awareness concerning attitudes toward prevention, HBV vaccination and testing, HCV screening and viral hepatitis treatment, 14 which may impact the Brazilian viral hepatitis elimination plan in the near future. 7 In this regard, knowledge about transmission, natural history and consequences of HCV 15 , 16 , 17 and HBV 17 , 18 , 19 , 20 infection in the general population from different parts of the world was reported to be inadequate even in hyperendemic areas of hepatitis B in Asia. 18 , 19 , 20 Due to its indolent course and lack of knowledge, many HBV- and HCV-positive patients were shown not to have confirmation of active infection or treatment to achieve sustained virological response, 21 , 22 many of them with advanced fibrosis or cirrhosis.…”

“…Education level and/or income were significantly associated not only to attitudes toward HBV vaccination but also toward HBV and HCV testing and evaluation of liver health, which may be related not only to better access to healthcare but also to increased awareness and health literacy as previously highlighted by other reports. 17 , 29 Overall, 41%–48% of the Brazilians have performed either testing for viral hepatitis, liver enzymes or any diagnostic imaging test to assess liver health. The frequency of the Brazilian population already tested for HBV and HCV seems to be higher when compared to other populations.…”

“…The frequency of the Brazilian population already tested for HBV and HCV seems to be higher when compared to other populations. 17 , 30 , 31 However, it is important to point out that approximately 100 million hepatitis B or C rapid tests have been distributed at SUS free of charge by the Brazilian Ministry of Health to primary care since 2011 in the effort to achieve viral hepatitis elimination. 28 Those tests were prioritized to particular population groups, including at-risk subjects 9 , 10 and pregnant women, and, regarding HCV, all Brazilians over 40 years, which nowadays correspond roughly to 36% of the Brazilian population.…”

Digital Marketing: A Unique Multidisciplinary Approach towards the Elimination of Viral Hepatitis

“…Data retrieved from social media about marginal communities can be very useful. For example, a survey in the US showed that awareness about hepatitis C virus is very low in a significant number of Hispanic and NH Asian young adults, who had never heard about HCV [191]. Authors of this study emphasized a social media campaign to educate targeted population about HCV screening.…”

Low disease awareness as a contributing factor to the high prevalence of hepatitis C infection in Tzukuan, a hyperendemic area of southern Taiwan

“…Similar results were also observed in U.S. adults with low English fluency who were less aware of HCV. 18 Notably, up to 68% of participants with abnormal liver biochemistry and 69% of those with advanced fibrosis (FIB-4 > 3.25) still lacked disease awareness of their HCV infection.…”