Skip to main content

Advertisement

Log in

Hepatitis C in African Americans

  • Published:
Current Hepatitis Reports Aims and scope Submit manuscript

Abstract

African Americans, with treatment failure rates at about 80%, remain one of the most difficult patient groups in which to eradicate hepatitis C. Infection morbidity in this patient population is compounded by limitations on access to specialist care. Preliminary data regarding liver transplantation even suggest that African Americans, relative to Caucasians, have worse outcomes after liver transplantation. Hence, a priority in hepatitis C research remains studying the immunologic mechanisms that affect host-virus interaction and their relevance to viral persistence and interferon response. In this review, we emphasize recent literature related to the sociologic, immunologic, and metabolic mechanisms that underlie the racial decrements in hepatitis C outcomes in African Americans.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Muir A, Bornstein J, Killenberg P, et al.: Peginterferon alfa-2b and ribavirin for the treatment of chronic hepatitis C in blacks and non-Hispanic whites. N Engl J Med 2004, 350:2265–2271.

    Article  PubMed  CAS  Google Scholar 

  2. Jeffers L, Cassidy W, Howell C, et al.: Peginterferon alfa-2a (40kd) and ribavirin for black American patients with chronic HCV genotype 1. Hepatology 2004, 39:1702–1708.

    Article  PubMed  CAS  Google Scholar 

  3. Conjeevaram H, Fried M, Jeffers L, et al.: Peginterferon and ribavirin treatment of African American and Caucasian American patients with hepatitis C genotype 1. Gastroenterology 2006, 131:470–477.

    Article  PubMed  CAS  Google Scholar 

  4. Shiffman M, Mihas A, Millwala F, et al.: Treatment of chronic hepatitis C virus in African Americans with genotypes 2 and 3. Am J Gastroenterol 2007, 102:761–766.

    Article  PubMed  CAS  Google Scholar 

  5. Nair S, Eustace J, Thuluvath P.: Effect of race on outcome of orthotopic liver transplantation: a cohort study. Lancet 2004, 10:834–841.

    Google Scholar 

  6. Nguyen G, Thuluvath P: Racial disparity in liver disease: biological, cultural, or socioeconomic factors. Hepatology 2008, 47:1058–1066.

    Article  PubMed  Google Scholar 

  7. Wiley T, Brown J, Chan J: Hepatitis C infection in African Americans: its natural history and histological progression. Am J Gastroenterol 2002, 97:700–706.

    Article  PubMed  Google Scholar 

  8. Alter M, Kruszon-Moran D, Nainan O, et al.: The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med 1999, 341:556–562.

    Article  PubMed  CAS  Google Scholar 

  9. Armstrong G, Wasley A, Simard E, et al.: The prevalence of hepatitis C virus infection in the United States, 1999–2002. Ann Intern Med 2006, 144:705–714.

    PubMed  Google Scholar 

  10. Villano S, Vlahov D, Nelson K, et al.: Persistence of viremia and the importance of long-term follow-up after acute hepatitis C infection. Hepatology 1999, 29:908–914.

    Article  PubMed  CAS  Google Scholar 

  11. Rosen H, Weston S, Im K, et al.: Selective decrease in hepatitis C virus-specific immunity among African Americans and outcome of antiviral therapy. Hepatology 2007, 46:350–358.

    Article  PubMed  CAS  Google Scholar 

  12. Marion T, Xing Y, Liu Z, et al.: HLA class II and race-dependent differences in immune response to HCV, susceptibility to chronic infection, and response to therapy [abstract 1033]. Presented at the 58th Annual Meeting of the American Association for the Study of Liver Diseases. Boston, MA; November 2–6, 2007.

  13. Golden-Mason L, Klarquist J, Wahed A, Rosen H: Cutting edge: programmed death-1 expression is increased on immunocytes in chronic hepatitis C virus and predicts failure of response to antiviral therapy: race-dependent differences. J Immunol 2008, 180:3637–3641.

    PubMed  CAS  Google Scholar 

  14. Park V, Mason B, Krushkal J, et al.: Hepatitis C hypervariable region 1: association of reduced selection pressure in African Americans with treatment failure. Dig Dis Sci 2007, 52:2540–2549.

    Article  PubMed  Google Scholar 

  15. Donlin M, Cannon N, Yao E, et al.: Pretreatment sequence diversity differences in the full-length hepatitis C virus open reading frame correlate with early response to therapy. J Virol 2007, 81:8211–8224.

    Article  PubMed  CAS  Google Scholar 

  16. Cohen M, Grey D, Cook J, et al.: Awareness of hepatitis C infection among women with and at risk for HIV. J Gen Intern Med 2007, 22:1689–1694.

    Article  PubMed  Google Scholar 

  17. Mehta S, Genberg B, Astemborski J, et al.: Limited uptake of hepatitis C treatment among injection drug users. J Community Health 2007, 33:126–133.

    Article  Google Scholar 

  18. Kanwal F, Hoang T, Spiegel B, et al.: Predictor of treatment in patients with chronic hepatitic C infection—role of patient versus nonpatient factors. Hepatology 2007, 46:1741–1749.

    Article  PubMed  CAS  Google Scholar 

  19. Leevy C: Consensus interferon and ribavirin in chronic hepatitis C who were non-responders to pegylated interferon alfa-2b and ribavirin. Dig Dis Sci 2008, 53:1961–1966.

    Article  PubMed  CAS  Google Scholar 

  20. Jacobson I, Brown R, McCone J, et al.: Impact of weight-based ribavirin with peginterferon alfa-2b in African Americans with hepatitis C virus genotype 1. Hepatology 2007, 46:982–990.

    Article  PubMed  CAS  Google Scholar 

  21. Conjeevaram H, Kleiner D, Everhart J, et al.: Race, insulin resistance and hepatic steatosis in chronic hepatitis C. Hepatology 2007, 45:80–87.

    Article  PubMed  CAS  Google Scholar 

  22. Lawitz E, Rodriguez-Torres M, Muir A, et al.: Antiviral effects and safety of telaprevir, peginterferon alfa-2a, and ribavirin for 28 days in hepatitis C patients. J Hepatol 2008, 49:163–169.

    Article  PubMed  CAS  Google Scholar 

  23. Eckhoff D, McGuire B, Young C, et al.: Race: a critical factor in organ donation, patient referral and selection, and orthotopic liver transplantation? Liver Transpl Surg 1998, 4:499–505.

    Article  PubMed  CAS  Google Scholar 

  24. Reid A, Resnick M, Chang Y, et al.: Disparity in use of orthotopic liver transplantation among blacks and whites. Liver Transpl 2004, 10:834–841.

    Article  PubMed  Google Scholar 

  25. Hong J, Kosari K, Benjamin E, et al.: Does race influence outcomes after primary liver transplantation? A 23-year experience with 2700 patients. J Am Coll Surg 2008, 206:1009–1018.

    Article  PubMed  Google Scholar 

  26. Ananthakrishnan A, Saeian K: Racial differences in liver transplantation outcomes in the MELD era. Am J Gastroenterol 2008, 103:901–910.

    Article  PubMed  Google Scholar 

  27. Siegel A, McBride R, El-Serag H, et al.: Racial disparities in utilization of liver transplantation for hepatocellular carcinoma in the United States, 1998–2002. Am J Gastroenterol 2008, 103:120–127.

    PubMed  Google Scholar 

  28. Freeman R: Liver transplantation for hepatocellular carcinoma: racial disparities? Am J Gastroenterol 2008, 103:128–13

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jaquelyn F. Fleckenstein.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Whitt, K.N., Fleckenstein, J.F. Hepatitis C in African Americans. Curr hepatitis rep 7, 139–144 (2008). https://doi.org/10.1007/s11901-008-0028-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11901-008-0028-9

Keywords

Navigation