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