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Racial/Ethnic Differences in Spontaneous HCV Clearance in HIV Infected and Uninfected Women

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Abstract

Background/Aims

Among individuals without human immunodeficiency virus (HIV), African Americans have lower spontaneous clearance of hepatitis C virus (HCV) than Caucasians, and women have higher clearance than men. Few studies report racial/ethnic differences in acute HCV in HIV infected, or Hispanic women. We examined racial/ethnic differences in spontaneous HCV clearance in a population of HCV mono- and co-infected women.

Methods

We conducted a cross sectional study of HCV seropositive women (897 HIV infected and 168 HIV uninfected) followed in the US multicenter, NIH-funded Women’s Interagency HIV Study (WIHS), to determine the association of race/ethnicity with spontaneous HCV clearance, as defined by undetectable HCV RNA at study entry.

Results

Among HIV and HCV seropositive women, 18.7 % were HCV RNA negative, 60.9 % were African American, 19.3 % Hispanic and 17.7 % Caucasian. HIV infected African American women were less likely to spontaneously clear HCV than Hispanic (OR 0.59, 95 % CI 0.38–0.93, p = 0.022) or Caucasian women (OR 0.57, 95 % CI 0.36–0.93, p = 0.023). Among HIV uninfected women, African Americans had less HCV clearance than Hispanics (OR 0.18, 95 % CI 0.07–0.48, p = 0.001) or Caucasians (OR 0.26, 95 % CI 0.09–0.79, p = 0.017). There were no significant differences in HCV clearance between Hispanics and Caucasians, among either HIV infected (OR 0.97, 95 % CI 0.57–1.66, p = 0.91) or uninfected (OR 1.45, 95 % CI 0.56–3.8, p = 0.45) women.

Conclusions

African Americans were less likely to spontaneously clear HCV than Hispanics or Caucasians, regardless of HIV status. No significant differences in spontaneous HCV clearance were observed between Caucasian and Hispanic women. Future studies incorporating IL28B genotype may further explain these observed racial/ethnic differences in spontaneous HCV clearance.

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Abbreviations

HIV:

Human immunodeficiency virus

HCV:

Hepatitis C virus

WIHS:

Women’s Interagency HIV Study

RNA:

Ribonucleic acid

IDU:

Intravenous drug use

HAART:

Highly active anti-retroviral therapy

HBV:

Hepatitis B virus

HBsAg:

Hepatitis B surface antigen

HBcAb:

Hepatitis B core antibody

HBsAb:

Hepatitis B surface antibody

SNP:

Single nucleotide polymorphisms

References

  1. Ghany MG, Strader DB, Thomas DL, et al. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology. 2009;49:1335–1374.

    Article  PubMed  CAS  Google Scholar 

  2. Edlin BR. Perspective: test and treat this silent killer. Nature. 2011;474:S18–S19.

    Article  PubMed  CAS  Google Scholar 

  3. Sulkowski MS, Thomas DL. Hepatitis C in the HIV-infected person. Ann Intern Med. 2003;138:197–207.

    Article  PubMed  Google Scholar 

  4. Vogel M, Rockstroh JK. Treatment of acute hepatitis C in HIV infection. J Antimicrob Chemother. 2010;65:4–9.

    Article  PubMed  CAS  Google Scholar 

  5. Sherman KE, Rouster SD, Chung RT, et al. Hepatitis C Virus prevalence among patients infected with human immunodeficiency virus: a cross-sectional analysis of the US adult AIDS clinical trials group. Clin Infect Dis. 2002;34:831–837.

    Article  PubMed  Google Scholar 

  6. Benhamou Y, Bochet M, Di Martino V, et al. Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients. The Multivirc Group. Hepatology. 1999;30:1054–1058.

    Article  PubMed  CAS  Google Scholar 

  7. Weber R, Sabin CA, Friis-Moller N, et al. Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med. 2006;166:1632–1641.

    Article  PubMed  Google Scholar 

  8. Yamakawa Y, Sata M, Suzuki H, et al. Higher elimination rate of hepatitis C virus among women. J Viral Hepat. 1996;3:317–321.

    Article  PubMed  CAS  Google Scholar 

  9. Bakr I, Rekacewicz C, El Hosseiny M, et al. Higher clearance of hepatitis C virus infection in females compared with males. Gut. 2006;55:1183–1187.

    Article  PubMed  CAS  Google Scholar 

  10. Grebely J, Raffa JD, Lai C, et al. Factors associated with spontaneous clearance of hepatitis C virus among illicit drug users. Can J Gastroenterol. 2007;21:447–451.

    PubMed  Google Scholar 

  11. Kelen GD, Green GB, Purcell RH, et al. Hepatitis B and hepatitis C in emergency department patients. N Engl J Med. 1992;326:1399–1404.

    Article  PubMed  CAS  Google Scholar 

  12. Alter MJ, Kruszon-Moran D, Nainan OV, 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 

  13. Seeff LB, Miller RN, Rabkin CS, et al. 45-year follow-up of hepatitis C virus infection in healthy young adults. Ann Intern Med. 2000;132:105–111.

    Article  PubMed  CAS  Google Scholar 

  14. Barkan SE, Melnick SL, Preston-Martin S, et al. The women’s interagency HIV study. WIHS collaborative study group. Epidemiology. 1998;9:117–125.

    Article  PubMed  CAS  Google Scholar 

  15. Melendez-Morales L, Konkle BA, Preiss L, et al. Chronic hepatitis B and other correlates of spontaneous clearance of hepatitis C virus among HIV-infected people with hemophilia. AIDS. 2007;21:1631–1636.

    Article  PubMed  Google Scholar 

  16. Operskalski EA, Mack WJ, Strickler HD, et al. Factors associated with hepatitis C viremia in a large cohort of HIV-infected and -uninfected women. J Clin Virol. 2008;41:255–263.

    Article  PubMed  Google Scholar 

  17. Bonacini M, Groshen MD, Yu MC, et al. Chronic hepatitis C in ethnic minority patients evaluated in Los Angeles County. Am J Gastroenterol. 2001;96:2438–2441.

    Article  PubMed  CAS  Google Scholar 

  18. Tobler LH, Bahrami SH, Kaidarova Z, et al. A case-control study of factors associated with resolution of hepatitis C viremia in former blood donors (CME). Transfusion. 2010;50:1513–1523.

    Article  PubMed  CAS  Google Scholar 

  19. Deterding K, Wiegand J, Gruner N, et al. The German Hep-Net acute hepatitis C cohort: impact of viral and host factors on the initial presentation of acute hepatitis C virus infection. Z Gastroenterol. 2009;47:531–540.

    Article  PubMed  CAS  Google Scholar 

  20. Thomas DL, Thio CL, Martin MP, et al. Genetic variation in IL28B and spontaneous clearance of hepatitis C virus. Nature. 2009;461:798–801.

    Article  PubMed  CAS  Google Scholar 

  21. Ge D, Fellay J, Thompson AJ, et al. Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance. Nature. 2009;461:399–401.

    Article  PubMed  CAS  Google Scholar 

  22. Clausen LN, Weis N, Astvad K et al. Interleukin-28B polymorphisms are associated with hepatitis C virus clearance and viral load in a HIV-1-infected cohort. J Viral Hepat. 2011;18:e66–74.

    Google Scholar 

  23. Rauch A, Kutalik Z, Descombes P et al. Genetic variation in IL28B is associated with chronic hepatitis C and treatment failure: a genome-wide association study. Gastroenterology 2010;138:1338–1345, 1345 e1–e7.

    Google Scholar 

  24. Yaeger R, Avila-Bront A, Abdul K, et al. Comparing genetic ancestry and self-described race in African Americans born in the United States and in Africa. Cancer Epidemiol Biomarkers Prev. 2008;17:1329–1338.

    Article  PubMed  CAS  Google Scholar 

  25. Villano SA, Vlahov D, Nelson KE, et al. Incidence and risk factors for hepatitis C among injection drug users in Baltimore, Maryland. J Clin Microbiol. 1997;35:3274–3277.

    PubMed  CAS  Google Scholar 

  26. Augenbraun M, Goedert JJ, Thomas D, et al. Incident hepatitis C virus in women with human immunodeficiency virus infection. Clin Infect Dis. 2003;37:1357–1364.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS) Collaborative Study Group with centers (Principal Investigators) at New York City/Bronx Consortium (Kathryn Anastos); Brooklyn, NY (Howard Minkoff); Washington, DC Metropolitan Consortium (Mary Young); The Connie Wofsy Study Consortium of Northern California (Ruth Greenblatt); Los Angeles County/Southern California Consortium (Alexandra Levine); Chicago Consortium (Mardge Cohen); Data Coordinating Center (Stephen Gange). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. The WIHS is funded by the National Institute of Allergy and Infectious Diseases [UO1-AI-35004, UO1-AI-31834, UO1-AI-34994, UO1-AI-34989, UO1-AI-34993, and UO1-AI-42590] and by the National Institute of Child Health and Human Development [UO1-HD-32632]. The study was co-funded by the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute on Deafness and Other Communication Disorders. Additional support was received through the National Institutes of Health [T32 DK060414 to MS].

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Medicine, Division of Gastroenterology and Hepatology, University of California, San Francisco, 513 Parnassus Avenue, Room S-357, San Francisco, CA, 94143-0358, USA

    Monika Sarkar & Marion G. Peters

  2. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA

    Peter Bacchetti

  3. Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA

    Phyllis Tien

  4. Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA

    Elizabeth Mileti

  5. Department of Medicine, CORE Center/Stroger Hospital of Cook County, Chicago, IL, USA

    Audrey L. French

  6. Department of Medicine, Division of Infectious Diseases, SUNY Downstate Medical Center, Brooklyn, NY, USA

    Brian R. Edlin

  7. Department of Medicine, Division of Infectious Diseases, Albert Einstein College of Medicine, Bronx, NY, USA

    Marla Keller

  8. Department of Epidemiology and Biostatistics, Johns Hopkins University, Baltimore, MD, USA

    Eric Seaberg

  9. Department of Medicine, University of Southern California, Los Angeles, CA, USA

    Marek J. Nowicki

  10. Department of Medicine, Division of Infectious Diseases, Georgetown University, Washington, DC, USA

    Mary Young

Authors
  1. Monika Sarkar
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  2. Peter Bacchetti
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  3. Phyllis Tien
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  4. Elizabeth Mileti
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  11. Marion G. Peters
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Correspondence to Monika Sarkar.

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Sarkar, M., Bacchetti, P., Tien, P. et al. Racial/Ethnic Differences in Spontaneous HCV Clearance in HIV Infected and Uninfected Women. Dig Dis Sci 58, 1341–1348 (2013). https://doi.org/10.1007/s10620-012-2486-8

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  • DOI: https://doi.org/10.1007/s10620-012-2486-8

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