Hepatitis C in Asian-Americans

Hepatitis B is highly prevalent among Asians and Asian-Americans, but hepatitis C in this population is less well characterized.

As described in the December 2006 American Journal of Gastroenterology, researchers conducted a retrospective survey to assess the demographics, epidemiology, and natural history of chronic hepatitis C in Asian-Americans. The study included 260 Asian-American chronic HCV patients referred to a single tertiary center in California.

Results

• 92% percent of the study participants were born in Asia.

•51% reported a history of unsafe therapeutic injections.

• Unsafe injection was a risk factor only for those with HCV exposure outside the United States.

•41% reported a history of blood transfusion, which was more frequent among those with exposure within the Unites States.

• Only 3.8% reported a history of injection drug abuse, which was more frequent among those with exposure within the United States.

•64.2% of patients had HCV genotype 1, 18.3% had genotype 2, and 11.3% had genotype 6.

•Patients with genotype 1 had a significantly lower sustained virological response rate to interferon-based therapy, compared to those with genotypes 2 or 6 (32.8%, 77.8%, and 69.2%, respectively).

•During a mean follow-up period of 6 years, 26 patients developed hepatocellular carcinoma (HCC).

• A logistic regression model revealed that the following factors predicted development of HCC:

- fibrosis stage 4 (OR 8.87);
- older age at presentation (55 vs 35 years: OR 3.45);
- baseline albumin level (3.0 vs 4.0 mg/dL: OR 3.47).

Conclusion

"Asian-Americans with a history of unsafe therapeutic injections must be screened for chronic hepatitis C," the authors recommended. "Antiviral treatment should be initiated prior to development of cirrhosis. Surveillance for HCC must be routinely performed in cirrhosis patients."

01/30/07

Reference
J T Cheng, C Hsien, H E Sun, and others. The emerging importance of chronic hepatitis C infection in Asian Americans. American Journal of Gastroenterology 101(12): 2737-2743. December 2006.