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Chronic liver disease among American Indian patients in the USA

The latest Journal of Clinical Gastroenterology examines chronic liver disease among American Indian Patient populations in the Southwestern United States.

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American Indians are disproportionately affected by chronic liver disease, yet little is known about its underlying etiologies in this group.

Dr Stephanie Bialek and colleagues determined the etiologies of chronic liver disease among American Indians.

5% had chronic liver disease, including those with decompensated cirrhosis
Journal of Clinical Gastroenterology

The team conducted a cross-sectional prevalence study at medical centers serving American Indian populations in Arizona and California.

Patients' records were reviewed to identify those with chronic liver disease.

ICD-9 codes and laboratory findings were abstracted to determine etiologies.

The researchers found that of the 30,698 American Indian patients seen at the Arizona center during 2000 to 2002, 5% had chronic liver disease, including those with decompensated cirrhosis.

Etiologies included alcohol, Hepatitis C, both of these together, or nonalcoholic fatty liver disease.

The team found among alcohol-related liver disease patients tested for Hepatitis C, 32% were positive.

Of the 6,074 American Indian patients seen at the California center during 2002 to 2003, 6% had chronic liver disease, including 13% with decompensated cirrhosis.

Etiologies included alcohol, Hepatitis C, and alcohol with Hepatitis C in this cohort.

In 33% of chronic liver disease patient at the 2 centers, no etiology could be identified; 30% to 45% had not been tested for Hepatitis C.

Dr Bialek‘s team concluded, "Alcohol-related liver disease and Hepatitis C were the most commonly identified etiologies among these American Indian patients with chronic liver disease in clinical care."

"Identifying American Indian and Alaska Native patients with chronic liver disease and providing treatment are critical for reducing disease burden."

J Clin Gastroenterol 2008: 42(7): 849-54
30 July 2008

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