Publication:

Determinants of confirmatory diagnosis of chronic hepatitis C among women of reproductive age: a surveillance-based analysis, 2018-2022

Background Women of reproductive age are disproportionately affected by chronic hepatitis C virus (HCV) infection, yet disparities in confirmatory diagnosis remain poorly understood. This study examined determinants of confirmed chronic HCV diagnosis among women aged 15-45 years in Maryland and assessed whether rural or urban residence influenced diagnostic confirmation.

Methods This cross-sectional study used secondary surveillance data from the Maryland National Electronic Disease Surveillance System (NEDSS) for women aged 15-45 years with chronic HCV reported between 2018 and 2022. We used logistic regression to assess the association between residence and confirmed diagnosis, controlling for demographic characteristics and period of diagnosis.

Results Among 2,197 women, 62.7% had a confirmed diagnosis and 37.3% were classified as probable cases. Bivariate analyses showed significant associations between diagnosis status and residence, age, and race. In unadjusted analysis, rural residents were more likely than urban residents to receive a confirmed diagnosis (OR=1.30, 95% CI: 1.09-1.54). After adjustment, residence was no longer significant (OR=1.07, 95% CI: 0.89-1.29). Women aged 26-35 years had higher odds of confirmed diagnosis than those aged 15-25 years (OR=1.32, 95% CI: 1.03-1.70). Compared with White women, Black women (OR=0.45, 95% CI: 0.35-0.58) and women of other racial backgrounds (OR=0.51, 95% CI: 0.26-0.99) had lower odds of confirmation.

Conclusions Age and race were stronger determinants than residence, highlighting persistent disparities in completion of HCV diagnostic evaluation and the need for targeted confirmatory testing efforts.