Background: Hepatitis C virus (HCV) is the most common cause of chronic liver disease in the United States. African Americans are known to have a higher prevalence of HCV and lower response to anti-HCV therapy.
GOAL: The aim of this study is to assess the differences in the prevalence of chronic HCV infection in according to patients’ ethnic background.
Study: We used the recent National Health and Nutrition Examination Survey with extensive clinical and laboratory data. Active HCV infection was defined as having HCV-positive antibody with detectable HCV RNA by polymerase chain reaction. HCV clearance was defined as HCV-positive antibody with negative HCV RNA. Clinico-demographic data were compared between anti-HCV positive individuals with or without HCV clearance. The stratum-specific χ2 test for independence was used. Logistic regression was used to identify independent predictors of HCV clearance. P-values ≤0.05 were considered statistically significant. All analyses were run using SAS 9.1 and SUDAAN 10.0.
Results: The cohort included 14,750 adults (age 47.6±0.75 y, 64% white, 21% African American, 10% Hispanics, and 63% male). Of these, 1.32±0.11% were anti-HCV positive with 75.94±4.72% having active HCV viremia. The only parameter significantly different between those who did or did not clear HCV was the proportion of African Americans: 8.0±3.7% versus 24.9±5.0%, P=0.0163. Indeed, the rate of HCV clearance was lowest among African Americans (9.3±3.5%) as compared with both whites (27.2±6.5%) and Hispanics 31.2±9.1% (P<0.05). In multivariate analysis, the only independent predictor of active HCV infection was African American race: odds ratio (95% confidence interval)=3.80 (1.31-11.06), P=0.0151.
Conclusions: African Americans not only have lower response to anti-HCV therapy but also are less likely to naturally clear HCV, potentially contributing to higher prevalence of HCV.