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Disease progression in HCV-infected African Americans may be slower

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    Am J Gastroenterol 2002; 97(3): 700-6 08 April 2002 Disease progression in HCV-infected African Americans may be slower HCV infection may have less immune
    Message 1 of 1 , Apr 29, 2002
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      Am J Gastroenterol 2002; 97(3): 700-6
      08 April 2002

      Disease progression in HCV-infected African Americans may be slower

      HCV infection may have less immune recognition in African Americans,
      which may result in a slower disease progression, according to a
      study reported in the March issue of the American Journal of
      Gastroenterology.

      A team from Chicago, Illinois, USA, determined the natural history of
      hepatitis C virus (HCV) infection in African Americans.

      The demographics, mode of infection, virological features, and
      histological progression of HCV infection in African Americans versus
      non-African Americans were retrospectively examined.

      A total of 355 patients met criteria based on adequate liver biopsy
      specimens and exclusion of other hepatic diseases.

      African Americans (n = 112) were found to be significantly more
      likely to be infected with genotype 1 virus (88%) than were
      non-African Americans (n = 243, 67%).

      Baseline HCV RNA levels were similar, although baseline ALT values
      were significantly lower in African Americans (80 �l vs 112 �l).

      African Americans were also significantly older at the time of
      presentation and were significantly more likely to be women.

      The researchers found that, in African Americans, there was a trend
      toward less cirrhosis (22% vs 30%) and significantly less piecemeal
      necrosis on liver biopsy.

      Non-African Americans had significantly higher fibrosis scores, ALT
      values, and piecemeal necrosis ratings, and tended to progress more
      rapidly to cirrhosis.

      This difference in histological progression between the two groups
      was not explained by differences in alcohol consumption.

      Dr T. E. Wiley, of the College of Pharmacy, at the University of
      Illinois at Chicago, concluded on behalf of fellow authors, "The
      lower ALT, piecemeal necrosis scores, and slower progression of
      fibrosis in African Americans may reflect less immunological
      recognition of HCV-infected liver cells."

      In an accompanying Editorial, Drs Damien B. Mallat and Lennox Jeffers
      point out that the study addresses a very important and lingering
      issue in the natural history of HCV.

      "Even though HCV infection in African Americans might have less
      immune recognition, which results in a slower disease progression,
      this issue needs further exploration in a randomized, controlled
      trial," they comment.

      "Only a few studies have been done to evaluate the natural history of
      HCV in African Americans. This underrepresentation has been
      detrimental to our understanding of the HCV epidemic in this group,"
      they concluded.

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