African American women with HIV/HCV less likely to die from liver disease

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 compared to other racial groups.

"Despite much study on racial differences in 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 co-infected with HIV/HCV who died from 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."

More information: "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.

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