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Hepatitis C in African Americans

Hepatitis C virus (HCV) infection demonstrates some significant differences related to race/ethnicity, as reviewed by Nikolaos Pyrsopoulos, MD, and Lennox Jeffers, MD, of the University of Miami in the February 2007 Journal of Clinical Gastroenterology.

"The prevalence of the disease is not the same across various races and a great epidemiologic disparity exists," the authors wrote. "Hepatitis C virus is more prevalent in the African American population with a higher rate of detectable viremia, predominance of genotype 1, and a higher viral load."

"Paradoxically," they continued, "the natural history of the disease and the progression to cirrhosis [in African Americans] is less accelerated, although the development of hepatocellular carcinoma is more evident."

They also noted that, "African Americans in particular are resistant to antiviral regimens," and the response rates to treatment with conventional interferon monotherapy, a combination of conventional interferon plus ribavirin, or a combination of pegylated interferon plus ribavirin are significantly lower compared with Caucasian patients.

Both genotype 1 HCV and high viral load are associated with poorer response to interferon-based therapy. In addition, there are on going studies to determine what other mechanisms may contribute to the lack of response in African Americans.

"An under-representation of African Americans in various study trials that are consequently on a list for a liver transplant have been noted, and [it] is postulated that the survival after liver transplantation is not equivalent to [that] reported for other races, for unclear reasons," the authors concluded.

N Pyrsopoulos and L Jeffers. Hepatitis C in African Americans. Journal of Clinical Gastroenterology 41(2): 185-193. February 2007.

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