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Primary biliary cirrhosis is more severe at presentation in non-Caucasions

This month's issue of Hepatology compares Caucasian, African American, and Hispanic patients with primary biliary cirrhosis in the United States.

News image

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Primary biliary cirrhosis is an uncommon chronic cholestatic liver disease that primarily afflicts young and middle-aged Caucasian women.

There are limited data on the clinical presentation and disease severity among non-Caucasian patients with this disease.

African Americans and Hispanics had more advanced disease
Hepatology

Dr Marion Peters and colleagues from California, USA examined differences in the severity of liver disease between Caucasian and non-Caucasian patients with primary biliary cirrhosis.

Patients were screened for enrollment in a large national multicenter clinical trial.

Demographic features, symptoms, physical findings, and laboratory tests obtained during screening were examined in 535 patients with primary biliary cirrhosis.

The investigative team assessed these factors with respect to ethnicity, gender, and antimitochondrial antibody status.

The investigators reported that 73 patients were non-Caucasian, of which 21 were African American, and 42 were Hispanic.

The team found that 47% of non-Caucasians vs 25% of Caucasians were ineligible for participation in the clinical trial, primarily because of greater disease severity.

African Americans and Hispanics were also more likely to have a lower activity level, more severe pruritus, and more advanced disease.

However, the mean age, male-to-female ratio, and seroprevalence of antimitochondrial antibody positivity were similar between the 2 groups.

Dr Peters' team concluded, "Liver disease severity at clinical presentation is higher among non-Caucasians than Caucasians with primary biliary cirrhosis."

"This cannot be explained by demographic or serologic features alone."

"Possible mechanisms underlying this health discrepancy are not clear, but increased awareness of primary biliary cirrhosis as a cause of chronic cholestatic liver disease is critical in evaluating non-Caucasian patients in the United States."

Hepatology 2007: 46(3): 769-75
10 September 2007

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