Hepatitis C virus (HCV) infection is more prevalent in black Americans than their white counterparts. Yet the natural course of HCV in black patients has not been defined.
In an attempt to remedy this, Kester Crosse and colleagues from The University of Maryland Baltimore School of Medicine, in Baltimore, Maryland, USA, performed a retrospective comparison of 87 black and 136 white American chronic hepatitis C patients.
Initial liver tests, HCV genotype and viral liver load as well as liver histology findings were assessed from the subjects, who had all been evaluated at the University of Maryland between 1995 and 1998.
Liver biopsy examinations were interpreted using the Knodell Histologic Activity Index (HAI) criteria.
The findings of the study show that black patients were older (46.3 years compared to 433 years for white patients). They were also more likely to be infected with HCV genotype 1 (95% versus 75%).
There was no major difference in the modes of HCV transmission, estimated duration of HCV infection or prevalence of alcohol abuse between either group.
| Liver necroinflammation was more severe in white patients than black patients|
|Clinical Gastroenterology & Hepatology|
Despite this, black patients had lower mean total HAI scores (7.6 vs. 8.7), periportal hepatocyte necrosis scores and liver fibrosis scores.
Black patients were found to have a lower mean serum alanine transaminase level (85.5 vs. 122.7), a result in keeping with lower hepatic necroinflammatory activity.
Serum iron levels were also lower in black patients than white patients, although there were no racial differences in the prevalence of increased iron studies and hepatic iron loading.
The researchers conclude that back chronic HCV patients have milder liver necroinflammation and fibrosis than white patients with similar HCV duration. They add that differences in liver histology were not explained by a variance in hepatic iron loading.