Current Gastroenterology Reports

, Volume 6, Issue 1, pp 66–70

Chronic hepatitis C in african americans and other minority groups

  • Jaquelyn Fleckenstein


Chronic hepatitis C virus (HCV) is the most common Blood borne infection in the United States. An estimated 2.7 million Americans are infected, with the greatest prevalence of infection in African Americans at 3.2%. African Americans account for 22% of Americans with HCV. Recent studies have shown that African Americans are less likely to have cirrhosis than similarly infected non-Hispanic white patients and are more likely to have genotype 1 infection and to develop hepatocellular carcinoma. Several studies have shown that the response rates of African Americans to interferon and ribavirin are significantly lower than those for non-Hispanic whites. Despite the relatively low percentage of African-American patients in these early studies, similar preliminary results are being found in larger prospective studies with the newer treatment regimens of pegylated interferon and ribavirin. Differences in immunologic status, viral kinetics, and iron studies have also been found in HCV-infected African-American patients. Less is known about Mexican Americans and other minority groups because they are poorly represented in clinical trials. Efforts at increasing racial diversity in clinical trials are ongoing.


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References and Recommended Reading

  1. 1.
    Alter MJ, Kruszon-Moran MS, Nainan O, et al.: The prevalence of hepatitis C infection in the United States, 1988 through 1994. N Engl J Med 1999, 341:556–562. Widely quoted study examining the prevalence of HCV infection in the US population.PubMedCrossRefGoogle Scholar
  2. 2.
    Hadziyannis SJ, Cheinquer H, Morgan T, et al.: Peginterferon alfa-2a (40 kD) (Pegasys) in combination with ribavirin (RBV): efficacy and safety results from a phase III, randomized, double-blind multicentre study examining effect of duration of treatment and RBV dose. J Hepatol 2002, 36(Suppl 1):S3.CrossRefGoogle Scholar
  3. 3.
    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. Retrospective study evaluating natural history of HCV infection in African-American patients.PubMedCrossRefGoogle Scholar
  4. 4.
    Fleckenstein JF, Ismail MK, Bockhold K, et al.: African American response rate to therapy for hepatitis C. Hepatology 1998, 28:283A.Google Scholar
  5. 5.
    Lauer GM, Walker BD: Medical progress: hepatitis C virus infection. N Engl J Med 2001, 345:41–52.PubMedCrossRefGoogle Scholar
  6. 6.
    Simmonds P: Viral heterogeneity of the hepatitis C virus. J Hepatol 1999, 31:54–60.PubMedCrossRefGoogle Scholar
  7. 7.
    Martell M, Esteban J, Quer J, et al.: Hepatitis C virus circulates as a population of different but closely related genomes: quasispecies nature of HCV genome distribution. J Virol 1992, 66:3225–3229.PubMedGoogle Scholar
  8. 8.
    Hoofnagle JH: Course and outcome of hepatitis C. Hepatology 2002, 36(Suppl):S21-S29.PubMedCrossRefGoogle Scholar
  9. 9.
    Reddy KR, Hoofnagle JF, Tong MJ, et al.: Racial differences in response to therapy with interferon in chronic hepatitis C. Consensus Interferon Study Group. Hepatology 1999, 30:787–793. Early study demonstrating racial disparity in treatment response.PubMedCrossRefGoogle Scholar
  10. 10.
    McHutchison JG, Poynard T, Pianko S, et al.: The impact of interferon plus ribavirin on response to therapy in black patients with chronic hepatitis C. The International Hepatitis Intervention Therapy Group. Gastroenterology 2000, 119:1317–1323.PubMedCrossRefGoogle Scholar
  11. 11.
    Seef LB: Natural history of chronic hepatitis C. Hepatology 2002, 35 (Suppl):S35-S46.Google Scholar
  12. 12.
    Sugimoto K, Stadanlick J, Ikeda F, et al.: Influence of ethnicity in the outcome of hepatitis C virus infection and cellular immune response. Hepatology 2003, 37:590–599. Examination of host-virus interactions that may help to explain racial disparity.PubMedCrossRefGoogle Scholar
  13. 13.
    National Institutes of Health. October 1, 2003.Google Scholar
  14. 14.
    Jeffers LJ, Cassidy W, Howell C, et al.: Peginterferon alfa-2a (40KD)(Pegasys) in combination with ribavirin in African American and Caucasian patients with HCV genotype 1: an interim report of a comparative, multicenter, efficacy and safety study. Hepatology 2002, 36:359A.Google Scholar
  15. 15.
    Mallat D, Young L, Milikowski C, et al.: The histopathological impact of race in veterans with HCV infection. Hepatology 2000, 32(Suppl 2):A281.Google Scholar
  16. 16.
    El-Serag HB, Mason AC: Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med 1999, 340:745–750.PubMedCrossRefGoogle Scholar
  17. 17.
    Liang TJ, Rehermann B, Seeff LB, et al.: Pathogenesis, natural history, treatment and prevention of hepatitis C. Ann Intern Med 2000, 132:296–305.PubMedGoogle Scholar
  18. 18.
    Muir AJ, Bornstein JD, Killenburg PG, et al.: Pegylated interferon alfa-2b and ribavirin for the treatment of chronic hepatitis C infection in African American and non-Hispanic whites: a preliminary report. Gastroenterology 2002, 122(Suppl 1):A-630.Google Scholar
  19. 19.
    Kinzie JL, Naylor PH, Nathani MG, et al.: African Americans with genotype 1 treated with interferon for chronic hepatitis C have a lower end of treatment response than Caucasians. J Viral Hepat 2001, 8:264–269.PubMedCrossRefGoogle Scholar
  20. 20.
    DeMaria N, Colantoni A, Idilman R, et al.: Impaired response to high-dose interferon treatment in African-Americans with chronic hepatitis C. Hepatogastroenterology 2002, 49:788–792.Google Scholar
  21. 21.
    Theodore P, Shiffman ML, Sterling RK, et al.: Intensive interferon therapy does not increase virologic response rates in African Americans with chronic hepatitis C. Dig Dis Sci 2003, 48:140–145.PubMedCrossRefGoogle Scholar
  22. 22.
    Layden TJ, Layden RE, Ribeiro RM, et al.: Mathematical modeling of viral kinetics: a tool to understand and optimize therapy. Clin Liver Dis 2003, 7:163–178.PubMedCrossRefGoogle Scholar
  23. 23.
    Layden-Almer JE, Ribeiro RM, Wiley T, et al.: Viral dynamics and response differences to therapy with interferon in HCV infected African American and white patients treated with interferon and ribavirin. Hepatology 2003, 37:1343–1350.PubMedCrossRefGoogle Scholar
  24. 24.
    Ioannou GN, Dominitz JA, Weiss NS, et al.: Racial differences in the relationship between hepatitis C infection and iron stores. Hepatology 2003, 37:795–801.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2004

Authors and Affiliations

  • Jaquelyn Fleckenstein
    • 1
  1. 1.Department of MedicineUniversity of Tennessee, MemphisMemphisUSA

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