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Race/Ethnicity-Specific Outcomes Among Chronic Hepatitis C Virus Patients Listed for Liver Transplantation

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Abstract

Background

Chronic hepatitis C virus (HCV) infection is a leading cause of hepatocellular carcinoma (HCC) and need for liver transplantation (LT). It is unclear if HCV-related LT outcomes vary by race/ethnicity.

Aims

We aim to evaluate ethnic disparities specifically among patients with chronic HCV in the USA.

Methods

Using data from the United Network for Organ Sharing 2003–2013 LT registry, we evaluated race/ethnicity-specific disparities in LT waitlist survival and probability of receiving LT among chronic HCV patients listed for LT.

Results

Among 43,478 HCV patients listed for LT (70.0% non-Hispanic white, 10.8% black, 16.3% Hispanic, 2.9% Asian), HCV-related LT waitlist registrations increased by 21.5% from 2003 to 2013. During this period, the proportion of HCV patients with HCC increased by 237%, and in 2013, HCV patients with HCC accounted for 33.0% of HCV-related waitlist registrations. When stratified by race/ethnicity, Hispanics with HCV had significantly lower waitlist mortality (OR 0.83; 95% CI 0.74–0.94; p < 0.01) compared to non-Hispanic whites, but no significant differences were seen among blacks and Asians. Furthermore, compared to non-Hispanic whites, Hispanics were significantly less likely to receive LT (OR 0.58; 95% CI 0.53–0.62; p < 0.001), but no differences were seen among blacks or Asians.

Conclusion

Among patients with chronic HCV in the USA, the MELD score has reduced race/ethnicity-specific disparities in waitlist mortality. However, Hispanic HCV patients had significantly better waitlist survival and lower probability of receiving LT, possibly reflecting slower disease progression compared to non-Hispanic whites with chronic HCV.

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Authors and Affiliations

  1. Department of Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA

    Joseph Ahn

  2. Division of Gastroenterology and Hepatology, Alameda Health System – Highland Hospital, Highland Hospital – Highland Care Pavilion 5th Floor, Endoscopy Unit, 1411 East 31st Street, Oakland, CA, 94602, USA

    Benny Liu, Taft Bhuket & Robert J. Wong

Authors
  1. Joseph Ahn
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  2. Benny Liu
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  3. Taft Bhuket
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  4. Robert J. Wong
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Corresponding author

Correspondence to Robert J. Wong.

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Conflict of interest

Robert Wong—Advisory board and research Grant from Gilead. Joseph Ahn, Benny Liu, and Taft Bhuket have no disclosures.

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Ahn, J., Liu, B., Bhuket, T. et al. Race/Ethnicity-Specific Outcomes Among Chronic Hepatitis C Virus Patients Listed for Liver Transplantation. Dig Dis Sci 62, 1051–1057 (2017). https://doi.org/10.1007/s10620-017-4469-2

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  • DOI: https://doi.org/10.1007/s10620-017-4469-2

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