Ethnic and Racial Differences in the Natural History of Hepatitis C

Abstract

Hepatitis C virus (HCV) infection is common in the UnitedStates and affects all ethnic groups. Important ethnic disparities exist in HCV severity, response to treatment, and progression after liver transplantation. Among patients with chronic HCV, African Americans tend to have less severe disease histologically, whereas Hispanics appear to have a more aggressive disease course compared with non-Hispanic Whites. In contrast, new data suggest that African Americans have more rapid HCV progression after liver transplantation relative to other ethnic groups. African Americans and Hispanics have lower sustained virologic response rates to pegylated interferon and ribavirin compared with non-Hispanic Whites. Awareness of these differences will help clinicians counsel diverse populations of patients on risk of progression, treatment outcome, and expectations after liver transplant. Future investigations of these differences should help in identifying mechanisms behind observed disparities and interventions to improve outcomes.