They hate him now. And really, he doesn't blame them. After all, doesn't he deserve their hate? Look at what he did. He betrayed the village by defecting to Orochimaru (it wasn't running, it wasn't), so in the end, everything else that happened as a consequence of that is his fault too.
Sakura, lying unconscious behind him.
Neji and Chouji, almost dying.
Naruto, and that look in his eyes as Sasuke's hand went through his chest.
But in the end, what other choice did he have? Because in the end there wasn't anybody, not Sakura, not Kakashi, and not Naruto, although he came the closest, that could equal Itachi. And so Sasuke did the only thing he could do. He chose Itachi.
He's always chosen Itachi, since before he even knew what a ninja was (although a part of him doesn't remember not knowing). Itachi has been his obsession, he has shaped his life. When he was younger, it was so he could see that proud look in his father's eyes, so that his family would look at him and not see 'Itachi's little brother' but Sasuke, so that Itachi himself would look at him and see him not as an annoying little brother but as an equal.
So he trained and trained and trained, but he was never good enough. No matter how hard he worked, how much he pushed himself, Itachi was always better. But even though that made Sasuke angry, somehow, it was still ok.
It was ok because he knew that even if his brother looked down on him, he looked down on him with love. It was in Itachi's eyes, as he told hid little brother 'tomorrow, tomorrow' and as he explained the legacy behind the Uchiha clan.
But it wasn't. Those memories are fake, tainted. Tainted by the memory of blood and screams and Itachi's laughter as he told Sasuke that it was nothing but a lie. So now he devotes himself to beating Itachi, this time for the sake of killing him, destroying him, as he destroyed everything Sasuke held dear.
Sasuke sometimes wonders what he'll feel, when Itachi's blood covers his hands, and he finally breathes his last breath.
Will he feel satisfaction, that his brother has finally died, that revenge his finally his?
Will he feel relief because he was able to accomplish his goal?
Will he feel sad, because despite everything, Itachi was his brother once, and Sasuke loved him like no one else?
Sasuke wonders if he'll cry when Itachi's dead.
Or will he feel nothing? Will he look down at the shell of his brother's body and simply be empty?
He doesn't know, just as he doesn't know what will happen after he kills Itachi. His purpose, his whole life has been shaped by that one person. What do you do when the thing your life revolves around is dead?
Will he go back to Sound, and allow Orochimaru to take his body?
Will he return to Konoha, to accusing stares, and death that awaits any missing nin?
Sasuke figures that it doesn't matter what he does after, because chances are that he'll be dead alongside his brother, that Itachi's last breath will coincide with his.
So really, isn't it better that everyone in Konoha hates him now? If they hate him, his death won't make them sad, might not even affect them at all.
He wonders if anyone will cry when they hear he's dead, or if they'll laugh instead.
Or maybe they'll feel relieved that the Sasuke problem is finally taken care of. And as an added bonus, he took the Itachi problem with him.
He wonders if anyone will care he's dead, if they'll even notice.
Sasuke knows it could've been different, he could've made it different. He could have chosen to stay, to not get into the box that would put him even more under Orochimaru's control, to go back with Naruto, instead of punching a whole through his chest.
In the end, he couldn't kill him. Not Naruto, his rival, his enemy, his friend. The one person who came close to filling the hole Itachi left. Sometimes, when they were together, the cold ghosts of the Uchiha family would leave him alone for a little while. Itachi wanted Sasuke to kill him, to sever all ties with everyone but Itachi himself. So it's a kind of victory, isn't it, that he didn't do what Itachi wanted.
Except it's not, because they all hate him now anyways, and his mind is still focused on Itachi. He pushes away those thoughts of home, of what might have been if he had acted differently. Because those thoughts bring nothing but regrets, and regrets make you slow. They make you weak.
And the one thing Sasuke will not be is weak. So he doesn't think about girlish smiles, or blue eyes, or orange books, because those thoughts just distract him. He knows if he trains hard enough, he can push them away, drown them out with exhaustion. If he just concentrates --
A kunai slices through his arm. The blood drips. Stupid. Stupid and careless and sloppy, three things he is not, three things he does not have time to be. He dodges another kunai, thrown by one of the sound ninjas, brings his hands together, and concentrates his chakra, blocking out everything else. Around him, the world explodes into fire.
He watches it burn, watches as it burns away thoughts, as it burns away feelings, as it burns away what might have been.
As it burns away everything except Itachi.