A NEW national study has revealed significant gaps in hepatitis C (HCV) care for children in the United States, raising concerns over access and treatment disparities. Despite clinical guidelines recommending treatment for children as young as three, fewer than one in three children diagnosed with HCV are being linked to appropriate care, and fewer than one in eight receive potentially curative treatment.
Using data from the TriNetX Research Network, researchers conducted a retrospective cohort analysis of 928 children diagnosed with HCV between 2000 and 2018. The study aimed to assess the progression through the HCV care cascade, diagnosis, linkage to care, and prescription of direct-acting antivirals (DAAs), which are highly effective in treating the virus.
The findings are concerning as only 32% of the children were linked to specialist care for HCV, and just 12% were prescribed a DAA. These figures indicate a substantial drop-off following diagnosis, undermining efforts to eliminate HCV in paediatric populations. Even more troubling are the racial and ethnic disparities identified. After adjusting for sex, birth cohort, and geographic region, Hispanic/Latinx children had more than double the odds of being linked to care compared to Black children, while white children had over triple the odds.
These disparities highlight an urgent need to address inequities in the healthcare system. Improving access to specialist care and treatment for all children, particularly Black children who appear disproportionately affected, will be essential to advancing national HCV elimination goals.
This study is the first to evaluate paediatric HCV care on a national scale and emphasises the importance of early intervention and equitable healthcare delivery. Targeted public health strategies and policy changes aimed at improving care linkage could significantly improve outcomes for children living with HCV across all communities.
Reference
Curtis MR et al. Disparities in linkage to care among children with hepatitis C virus in the United States. Pediatrics. 2025;155(5):e2024068565. doi:10.1542/peds.2024-068565.
