Racial differences in the relationship between hepatitis C infection and iron stores

Ioannou, George N.; Dominitz, Jason A.; Weiss, Noel S.; Heagerty, Patrick J.; Kowdley, Kris V.

doi:10.1053/jhep.2003.50147

Cited by 52 publications

(36 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Racial differences may occur in the performance of tests to screen for HCV-related liver fibrosis, just as racial differences occur in spontaneous clearance of HCV infection 9,25 and response to interferon alfa therapy for chronic hepatitis C. 26,27 Slower natural history of HCV-related fibrosis has also been reported in African Americans. 28,29 These data underscore the importance of validating screening tests in a variety of clinical settings.…”

Section: Discussionmentioning

confidence: 92%

Progression of liver fibrosis among injection drug users with chronic hepatitis C

et al. 2006

View full text Add to dashboard Cite

Although most hepatitis C virus (HCV) infections are acquired by injection drug use, prospective data on the progression of liver fibrosis are sparse. Baseline liver biopsies were obtained (1996-1998) on a random sample of 210 out of 1667 HCV-positive injection drug users (IDUs). Subjects were followed biannually, with a second biopsy offered to those eligible. Paired biopsies were scored 0 to 6 (modified Ishak score), significant fibrosis was defined as score 3 or greater, and progression of fibrosis was defined as an increase 2 or more units or clinical evidence of end-stage liver disease. Predictive values of blood markers [FibroSURE, aspartate aminotransferase-to-platelet-ratio index (APRI) and alanine aminotransferase (ALT)] were assessed for detection of contemporaneous and future liver fibrosis. Among 119 prospectively followed IDUs, 96% were African American; 97% HCV genotype 1a/b; 27% HIV-infected, and median age was 42 years. Most (90.7%) did not have significant liver fibrosis at first biopsy. Although predictive value for detecting insignificant fibrosis at first biopsy was greater than 95% for FibroSURE, APRI, and ALT, specificities were 88.9%, 72.7%, and 72.7%, respectively. After 4.2 years median follow-up, 21% had progression of fibrosis, which was significantly associated with serum level of HCV RNA and ALT. No serological test had predictive value greater than 40% for contemporaneous or future significant fibrosis. Even initial biopsy result had only a 30.4% value for predicting future significant fibrosis. In conclusion, significant liver fibrosis and progression were detected in some, but not most, IDUs in this cohort. In this setting with low fibrosis prevalence, FibroSURE, ALT, and APRI tests predict insignificant fibrosis; however, further work is needed to find noninvasive markers of significant liver fibrosis. (HEPATOLOGY 2006;43: 788-795.)

show abstract

Section: Discussionmentioning

confidence: 92%

Progression of liver fibrosis among injection drug users with chronic hepatitis C

et al. 2006

View full text Add to dashboard Cite

show abstract

“…The causes of racial variation are still unclear. Some factors, like cytokine production and hepatic iron level, have been considered as the origin of inter-ethnic differences in prior investigations [41,42]. Since the strong associations of IL28B gene polymorphisms with HCV clearance have been demonstrated, SNPs near the IL28B gene are thought to be the leading cause of racial variation of HCV clinical outcomes [43].…”

Section: Discussionmentioning

confidence: 99%

Polymorphisms near <b><i>Interleukin 28B</i></b> Gene Are Not Associated with Hepatitis B Virus Clearance, Hepatitis B e Antigen Clearance and Hepatocellular Carcinoma Occurrence

et al. 2013

View full text Add to dashboard Cite

Background: Polymorphisms near the IL28B gene have been proposed to be strongly associated with treatment response and the rate of spontaneous clearance of hepatitis C virus infection, and treatment response of hepatitis B virus (HBV) infection. In this study, we aimed to determine whether these polymorphisms could affect natural courses of HBV infection. Methods: Genetic variations were identified through direct DNA sequencing using TaqMan assay in 1,439 patients with past or present HBV infection. Subjects included 404 spontaneously recovered patients, 313 chronic hepatitis B (CHB) patients, 305 liver cirrhosis (LC) patients and 417 hepatocellular carcinoma (HCC) patients. Three polymorphisms near the IL28B gene, rs8099917T>G, rs12979860C>T and rs12980275A>G, were identified. Associations between these polymorphisms and HBV clearance, hepatitis B e antigen (HBeAg) clearance as well as HCC occurrence among patients were analyzed using logistic regression analyses adjusted for age and gender. Results: There were no significant associations between these polymorphisms and the HBV clearance both in CHB and LC groups. Similarly, these polymorphisms showed no significant associations with HBeAg clearance and the occurrence of HCC either. Discussion: No significant association was identified between polymorphisms near the IL28B gene and the natural courses of chronic HBV infection, including the HBV clearance and HCC occurrence.

show abstract

“…Moreover, the association between HCV infection and elevated hepatic iron stores was markedly more pronounced in African Americans (odds ratio: 17.8; 95% CI: 5.1-63) than in other races/ethnicities. 35 However, it is not clear whether the presence of elevated iron stores is a causative factor or a just a marker of poor response to therapy. Interestingly, a retrospective study of prison inmates who underwent directly observed interferon and ribavirin therapy for genotype 1 HCV showed no differences in SVR.…”

Section: Racial Disparities In the Treatment Of Liver Diseasementioning

confidence: 99%

Racial disparity in liver disease: Biological, cultural, or socioeconomic factors

Nguyen¹,

Thuluvath²

2008

Hepatology

144

136

View full text Add to dashboard Cite

Chronic liver diseases are a major public health issue in the United States, and there are substantial racial disparities in liver cirrhosis-related mortality. Hepatitis C virus (HCV) is the most significant contributing factor in the development of chronic liver disease, complications such as hepatocellular carcinoma, and the need for liver transplantation. In the United States, African Americans have twice the prevalence of HCV seropositivity and develop hepatocellular carcinoma at more than twice the rate as whites. African Americans are, however, less likely to respond to interferon therapy for HCV than are whites and have considerably lower likelihood of receiving liver transplantation, the only definitive therapy for end-stage liver disease. Even among those who undergo transplantation, African Americans have lower 2-year and 5-year graft and patient survival compared to whites. We will review these racial disparities in chronic liver diseases and discuss potential biological, socioeconomic, and cultural contributions. An understanding of their underlying mechanisms is an essential step in implementing measures to mollify racially based inequities in the burden and management of liver disease in an increasingly racially and ethnically diverse population. (HEPATOLOGY 2008;47:1058-1066

show abstract

Racial differences in the relationship between hepatitis C infection and iron stores

Cited by 52 publications

References 48 publications

Progression of liver fibrosis among injection drug users with chronic hepatitis C

Progression of liver fibrosis among injection drug users with chronic hepatitis C

Polymorphisms near <b><i>Interleukin 28B</i></b> Gene Are Not Associated with Hepatitis B Virus Clearance, Hepatitis B e Antigen Clearance and Hepatocellular Carcinoma Occurrence

Racial disparity in liver disease: Biological, cultural, or socioeconomic factors

Contact Info

Product

Resources

About