Original articleRacial differences in liver inflammation and fibrosis related to chronic hepatitis C
Section snippets
Study design
This retrospective cohort study was approved by the University of Maryland Institutional Review Board. We reviewed the medical records of all patients who were evaluated for chronic HCV at the University of Maryland Hepatology Ambulatory Clinic between 1995 and 1998 and who had liver biopsy slides available for review. Each patient had serum antibodies to HCV (EIA-2; Ortho Diagnostics, Bridgewater, NJ) and detectable serum HCV-RNA levels. The patient’s race was identified as black or white in
Demographic and viral data
The demographic data are summarized in Table 1. Black HCV patients were significantly older than white HCV patients. However, the ratio of women to men, estimated duration of HCV, and modes of HCV transmission (injection drug use, 35.3.5% vs. 32.4%; blood product transfusions before 1992, 20.6% vs. 20.5%; unknown, 23.0% vs. 22.8%) were similar in black and white patients. The prevalence of alcohol abuse was the same in the 2 races (P = 0.11). Ninety-five percent of black patients and 75% of
Discussion
We found significant differences in the clinical and liver biopsy manifestations of chronic HCV in black and white patients. Despite a similar duration of HCV and rate of alcohol abuse, black HCV patients had a lower mean serum ALT level, lower serum iron level, and less liver necroinflammation and fibrosis. These differences in liver histology were not related to varied durations of HCV infection, alcohol abuse, or hepatic iron loading.
Two previous studies have investigated racial and ethnic
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