A new study shows that African American women
coinfected with human immunodeficiency virus (HIV) and hepatitis C virus
(HCV) are less likely to die from liver disease than Caucasian or
Hispanic women. Findings in the November issue of Hepatology,
a journal published by Wiley on behalf of the American Association for
the Study of Liver Diseases, indicate that lower liver-related mortality
in African American women was independent of other causes of death.
Medical evidence reports that nearly five million
Americans are infected with HCV, with 80% having active virus in their
blood (viremia). Moreover, prior research found that one third of those
with HIV are co-infected with HCV—the second leading cause of death
among those with HIV. Studies also show that while HCV clearance
(elimination of the virus spontaneously or with treatment) is lower
among African Americans, once chronically infected this group seems to
develop less fibrosis and liver inflammation compared to other racial
“Despite much study on racial differences in
hepatitis C development, it remains unclear how race impacts
liver-related death in those with HCV or HIV/HCV co-infection,” said Dr.
Monika Sarkar from the University of California, San Francisco and lead
author of the current study examining racial differences and mortality
among women with HIV and HCV.
The UCSF team followed 794 subjects who were part of
the Women’s Interagency HIV study, which was funded by the National
Institutes of Health (NIH). Those women in the follow-up study included
140 Caucasians (62%), 159 Hispanics (20%), and 495 African Americans
(18%). Study participants were seen twice each year to have detailed
health histories, physical exams, interviews, and clinical testing.
During a median follow-up of nearly 9 years,
researchers documented 438 deaths; 37% from HIV/AIDS and 11% due to
liver-related disease. Nearly 56% of African Americans, 56% of
Caucasians and 52% of Hispanics died during follow-up. The team reports
that liver disease was the primary cause of death in 21% of Hispanics,
14% of Caucasians, and only 8% of African Americans.
“Our findings indicate that the number of African
American women co-infected with HIV/HCV who died from liver disease was
significantly lower than Caucasian and Hispanic women with the same
diseases,” concludes Dr. Sarkar. “Further studies are needed to
understand the reasons for such a discrepancy in liver-related mortality
among these racial groups.”
Full citation: “Lower Liver-Related Death in
African American Women with HIV/HCV Co-Infection Compared to Caucasian
and Hispanic Women.” Monika Sarkar, Peter Bacchetti, Audrey L French,
Phyllis Tien, Marshall J Glesby, Marek Nowicki, Michael Plankey, Stephen
Gange, Gerald Sharp, Howard Minkoff and Marion G Peters for the Women’s
Interagency HIV Study (WIHS). Hepatology; (DOI: 10.1002/hep.25859); Print Issue Date: November, 2012.
About the Journal
Hepatology is the premier publication in the field of liver
disease, publishing original, peer-reviewed articles concerning all
aspects of liver structure, function and disease. Each month, the
distinguished Editorial Board monitors and selects only the best
articles on subjects such as immunology, chronic hepatitis, viral
hepatitis, cirrhosis, genetic and metabolic liver diseases and their
complications, liver cancer, and drug metabolism. Hepatology is published on is published by Wiley on behalf of the American Association for the Study of Liver Diseases (AASLD). For more information, please visit http://wileyonlinelibrary.com/journal/hep.
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