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Wiley InterScience | ||
  The American Journal of GastroenterologyVolume 101 Issue 8, Pages 1817 - 1823 Published Online: 22 Jun 2006 © 2008 American College of Gastroenterology/Blackwell Publishing Official publication of the American College of Gastroenterology
Abstract | References | Full Text: HTML, PDF (Size: 118K) | Related Articles | Citation Tracking  More Advanced Hepatic Fibrosis in Hispanics with Chronic Hepatitis C Infection: Role of Patient Demographics, Hepatic Necroinflammation, and Steatosis Copyright 2006 by Am. Coll. of Gastroenterology (Am J Gastroenterol 2006;101:1817–1823) ABSTRACTBACKGROUND AND AIMS: We sought to assess whether Hispanics have more advanced hepatitis C virus (HCV)-related liver disease than non-Hispanic whites (NHW) and to identify contributory factors. PATIENTS AND METHODS: Patients were recruited from the Los Angeles county hepatitis clinic. Liver fibrosis and necroinflammation (NI) were assessed by the Ishak scoring system. Hepatic steatosis was graded as 0–4. RESULTS: A total of 232 patients were evaluated, 63 NHW and 169 Hispanic. Hispanics were older and had a higher prevalence of blood transfusion (40%vs 21%), obesity (body mass index > 30) (47%vs 21%), diabetes mellitus (DM) (16%vs 5%), and hepatic steatosis (79%vs 47%), p < 0.02. Independent predictors of hepatic steatosis were Hispanic ethnicity (odds ratio [OR] 3.8, 95% CI 1.7–8.7, p= 0.001) and obesity (OR 5.7, 95% CI 2.3–14.1, p= 0.0002). Compared with NHW, Hispanics also had higher fibrosis stage (3.3 ± 2 vs 2.3 ± 6.9, p= 0.001), NI grade (6.4 ± 1.8 vs 5.6 ± 1.6, p= 0.002), and faster fibrosis progression/yr (0.14 ± 0.09 vs 0.09 ± 0.07, p= 0.0002). Presence of DM (OR 2.9, p= 0.02), grade 1–2 hepatic steatosis (OR 2.3, p= 0.03), AST/ALT > 1 (OR 4.3, p= 0.01), NI grade (OR 1.7, p < 0.0001), age at biopsy (OR 1.1, p < 0.0001), and serum bilirubin (OR 5.4, p < 0.0001) were independent predictors of fibrosis stage ≥4. CONCLUSION: This study confirms that Hispanics have more advanced hepatic fibrosis than NHW. This is related to older age, higher NI grade, and greater prevalence of hepatic steatosis and DM. Received December 28, 2005; accepted March 10, 2006. |  |
