Histological Versus Clinical Cirrhosis in Chronic Hepatitis C: Does Race/Ethnicity Really Matter?
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Liver fibrosis progression in hepatitis C virus (HCV) infection has been in part associated with race/ethnicity. Little is known of the frequency of clinical cirrhosis in Asian patients in the US.
To compare histological and clinical features of chronic hepatitis C (CHC) in a multiethnic cohort of patients.
Retrospective query of an electronic medical registry for CHC patients evaluated from 1999 to 2005. Histological cirrhosis was defined as advanced METAVIR fibrosis score at biopsy. Clinical cirrhosis was defined as any of: varices, ascites, or splenomegaly. Liver cirrhosis was defined as either histological or clinical cirrhosis. Chi-square tests, t tests, and logistic regression method were used for data analysis.
Six hundred and ninety-two patients were categorized into four racial-ethnic groups: 292 Caucasian (C), 145 Hispanic (H), 121 African American (AA), and 134 Asian (As) patients. Median age of AA (54 years) and As (53) was higher than C (52), or H (50) (p < 0.05). H patients had a higher percentage of alcohol abuse (60%) than AA and C (42–44%) and As (14%; p < 0.0001). Body mass index (BMI) was significantly lower in Asians compared to all other groups (p < 0.0001). Features of the metabolic syndrome were common, ranging from 28% in As to 72% in H patients. Liver cirrhosis was found in 53% H, 35% C, 29% As, and 19% AA. In multivariable analysis, only alcohol abuse, BMI, diabetes mellitus (DM), and age were significantly associated with liver cirrhosis. There was a trend for AA to have less cirrhosis, either histological or clinical (p = 0.08).
Using only histology, liver cirrhosis was significantly underestimated. In our cohort, severity of CHC was not clearly affected by race when alcohol use and features of the metabolic syndrome were taken into consideration. However, there was a trend for African Americans to have lower cirrhosis rates.
- Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. The OBSVIRC METAVIR, CLINIVIR, and DOSVIRC groups. Lancet. 1997;349:825–832. CrossRef
- Bonacini M, Groshen MD, Yu MC, Govindarajan S, Lindsay KL. Chronic hepatitis C in ethnic minority patients evaluated in Los Angeles County. Am J Gastroenterol. 2001;96:2438–2441. CrossRef
- Wiley TE, Brown J, Chan J. Hepatitis C infection in African Americans: its natural history and histological progression. Am J Gastroenterol. 2002;97:700–706. CrossRef
- D’Souza R, Glynn MJ, Ushiro-Lumb I, et al. Prevalence of hepatitis C-related cirrhosis in elderly Asian patients infected in childhood. Clin Gastroenterol Hepatol. 2005;3:910–917. CrossRef
- Verma S, Bonacini M, Govindarajan S, Kanel G, Lindsay KL, Redeker A. More advanced hepatic fibrosis in Hispanics with chronic hepatitis C infection: role of patient demographics, hepatic necroinflammation, and steatosis. Am J Gastroenterol. 2006;101:1817–1823. CrossRef
- Cheung RC, Currie S, Shen H, et al. Chronic hepatitis C in Latinos: natural history, treatment eligibility, acceptance, and outcomes. Am J Gastroenterol. 2005;100:2186–2193. CrossRef
- Fartoux L, Chazouilleres O, Wendum D, Poupon R, Serfaty L. Impact of steatosis on progression of fibrosis in patients with mild hepatitis C. Hepatology. 2005;41:82–87. CrossRef
- Castera L, Hezode C, Roudot-Thoraval F, et al. Worsening of steatosis is an independent factor of fibrosis progression in untreated patients with chronic hepatitis C and paired liver biopsies. Gut. 2003;52:288–292. CrossRef
- Histological Versus Clinical Cirrhosis in Chronic Hepatitis C: Does Race/Ethnicity Really Matter?
Digestive Diseases and Sciences
Volume 57, Issue 3 , pp 771-776
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- Springer US
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- Hepatocellular cancer
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- 1. Department of Transplantation, California Pacific Medical Center, 2340 Clay Street, Suite 308, San Francisco, CA, 94115, USA
- 2. University of Minnesota, Minneapolis, MN, 55455, USA
- 3. Norris Cancer Center, Los Angeles, CA, 90033, USA