Our results indicate that although HCV infection can be self-limited or associated with ESLD, the majority of adults have persistent viremia without clinically demonstrable liver disease. Further research is needed to explain the less frequent clearance of HCV infection among black persons and to improve utilization of treatment for those infected in the context of injection drug use. JAMA. 2000;284:450-456

Objective To evaluate evidence for differences in pediatric brain tumor diagnoses by race and ethnicity using a cross-sectional study design in individuals with neurofibromatosis type 1 (NF1). Study design Subjects with NF1 were ascertained from the NF1 Patient Registry Initiative (NPRI) and through a clinical record database of patients at a large academic medical center. Logistic regression was employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to analyze differences in the odds of brain tumor diagnosis by race (White, Black, Asian, Other/Unknown) and ethnic (Hispanic vs. non-Hispanic) groups. Results Data from a total of 1546, 629, and 2038 individuals who were ascertained from the NPRI, clinical records, and pooled datasets were analyzed, respectively. After adjusting for birth year, we observed a significantly reduced odds of brain tumor diagnoses in individuals self identified or clinically reported as Black (OR=0.13, 95% CI 0.05–0.31), Asian (OR=0.15, 95% CI 0.04–0.64), and Other/Unknown (OR=0.61, 95% CI 0.41–0.93) race compared with those with reported as White race. There was no significant difference in the odds of pediatric brain tumor diagnosis by Hispanic ethnicity. Conclusion Consistent with prior smaller studies, these data suggest that pediatric brain tumor diagnoses vary by race in individuals with NF1. Reasons underlying observed differences by race warrant further investigation.

Background: In drug users, viral hepatitis C, alcohol abuse, and drug use are three interconnected public health challenges. Methods: This study assessed the impact of alcohol on hepatitis C screening and hepatic fi brosis in this patient population. In total, 934 substance users were included and divided into three groups: Group A, alcohol use disorder only (n = 511); Group ISDU, intravenous and snorting drug users (n = 142); Group ISDAU, intravenous and snorting drug users with alcohol use disorder (n = 281). A FibroScan was performed fi rst, after which participants were proposed to undergo screening for HCV. Results: The HCV screening rate was signifi cantly lower in Group A (62%) than in the ISDAU or ISDU groups (81% and 85% respectively) (p<0.001). The rate of HCV seropositivity was lower in Group A (4.4%), whereas it was signifi cantly higher in the ISDAU group than ISDU group (42.3% vs 30.0%, p = 0.02). The rates of signifi cant fi brosis and severe fi brosis were higher in Group A (34% and 21%) and the ISDAU group (29% and 18%) than in ISDU (15% and 7%) (p<0.001). While entering, in addition to the group, age, gender, smoking status (cannabis and tobacco), drug consummation, HCV seropositivity, and BMI as covariables in a multivariate model, only age correlated with fi brosis (p<0.001). Considering age, there was no difference in impact among the different substances on the fi brosis score. Conclusion: Alcohol consumption impacts the health status of drug users. It is thus appropriate to early identify alcohol consumption in drug users and consider alcohol as a risk factor for severe fi brosis and HCV transmission. Alcohol consumption warrants the strengthening of HCV screening and hepatic fi brosis assessment.