title: A comparison of the spectrum of chronic hepatitis C virus between Caucasians and African Americans.
abstract: OBJECTIVE
  Differences in hepatitis C virus (HCV)-related liver disease between Caucasians and African Americans remain controversial.
  
  
  METHODS
  We performed a retrospective analysis of 302 consecutive inmates in the Virginia Department of Corrections evaluated for HCV between October 1998 and July 2002. All subjects were anti-HCV positive, HCV treatment naive, human immunodeficiency virus and HBV negative, and had compensated liver disease.
  
  
  RESULTS
  The mean age of the cohort was 41 years; they were 91% male and 51% Caucasian. The mean ALT level was 94 U/L, 49% had a normal ALT level, and 80% were genotype 1. The mean Knodell histologic activity index (HAI) was 7.03, with bridging fibrosis in 18% and cirrhosis in 6%. When analyzed by race, the mean ALT level (106 vs. 79 U/L; P = 0.01), proportion with normal ALT level (46% vs. 57%; P = 0.06), and proportion with genotype 1 (67% vs. 94%; P < 0.001) were different between Caucasians and African Americans, respectively. Although the HAI and proportion with bridging fibrosis/cirrhosis were similar between groups, African Americans had lower piecemeal necrosis (1.41 vs. 1.72; P = 0.034) and fibrosis (1.12 vs. 1.40; P = 0.047) scores compared to Caucasians. Multivariate analysis demonstrated that age, ALT, and race were significant independent variables associated with total HAI, piecemeal necrosis, and fibrosis scores.
  
  
  CONCLUSIONS
  Although the overall spectrum of liver disease is similar, African Americans have less piecemeal necrosis and lower fibrosis scores independent of age and ALT compared with Caucasians.
authors.affiliation: Division of Gastroenterology, Virginia Commonwealth University Medical Center, Richmond 23298-0341, USA. rksterli@hsc.vcu.edu
authors.forename: Richard K
authors.initials: RK
authors.lastname: Sterling
authors.forename: R Todd
authors.initials: RT
authors.lastname: Stravitz
authors.forename: Velimir A
authors.initials: VA
authors.lastname: Luketic
authors.forename: Arun J
authors.initials: AJ
authors.lastname: Sanyal
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Contos
authors.forename: A Scott
authors.initials: AS
authors.lastname: Mills
authors.forename: Mitchell L
authors.initials: ML
authors.lastname: Shiffman
mesh_terms: D000328:Adult; D001741:Black or African American; D000410:Alanine Transaminase / Q000097:blood; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000201:enzymology / Q000208:ethnology* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000201:enzymology / Q000208:ethnology* / Q000821:virology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011330:Prisons; D014768:Virginia; D044465:White People
chemical_list: D000410:Alanine Transaminase