ArticleJournal of viral hepatitis2026
Differing Epidemiology of Chronic Hepatitis C Infection, Treatment, and Outcomes Among Migrants and Australian-Born Patients.
Article in Journal of viral hepatitis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The burden of hepatitis C virus (HCV) infection often falls disproportionately on migrant populations within high-income countries. Differences in health literacy, language, comorbidities, and HCV genotype may influence HCV natural history. 3537 persons including 652 migrants treated for HCV infection with direct-acting antiviral (DAA) (2016-2021) were analysed. We describe the epidemiology of HCV in migrant people compared to Australian-born individuals and examine rates of sustained viral response (SVR), advanced liver fibrosis, cirrhosis, and all-cause mortality. Multivariable logistic and Cox regression analyses examined differences by migrant status. At enrolment, Australian-born patients were younger (mean 51.5 vs. 54.2 years; p < 0.001) and more likely to report injection drug use (p = 0.011), risky alcohol use (p < 0.001), or opioid replacement therapy (p < 0.001). Among migrants, diabetes (13.9% vs. 10.3%; p = 0.008), hepatitis B virus (HBV) exposure (43.3% vs. 29.7%; p < 0.001), active HBV infection (3.1% vs. 1.6%; p = 0.033), and genotypes 4, 5, and 6 (18.3% vs. 6.6%; p < 0.001) was more common. Overall SVR rates were comparable (p = 0.69), but SVR rates among migrants with cirrhosis were lower (88.2% vs. 95.2%; p = 0.002). Advanced fibrosis (24.5%), cirrhosis (35.0%), and five-year survival did not differ by migrant status (all p > 0.05). In migrants, genotype 3 was associated with more advanced liver fibrosis (adj-OR = 1.70, 95% CI 1.40-2.06) and cirrhosis (adj-OR = 1.74, 95% CI 1.48-2.04; p < 0.001), relative to Australian-born patients. Genotypes 2, 4 and 6 HCV were not associated with liver fibrosis and cirrhosis (all p > 0.05). In conclusion, migrants experienced equivalent SVR and rates of liver fibrosis and cirrhosis, and have equivalent or better survival compared to Australian-born patients.
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