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 the journal Hepatology indicate that lower liver-related mortality in African-American women was independent of other causes of death.

Medical evidence reports that nearly 5 million Americans are infected with HCV, with 80 percent having active virus in their blood (viremia). Moreover, prior research found that one-third of those with HIV are co-infected with HCVthe 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 groups.

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, says 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 Womens Interagency HIV study, which was funded by the National Institutes of Health (NIH). Those women in the follow-up study included 140 Caucasians (62 percent), 159 Hispanics (20 percent), and 495 African Americans (18 percent). 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 nine years, researchers documented 438 deaths; 37 percent from HIV/AIDS and 11 percent due to liver-related disease. Nearly 56 percent of African-Americans, 56 percent of Caucasians and 52 percent of Hispanics died during follow-up. The team reports that liver disease was the primary cause of death in 21 percen of Hispanics, 14 percen of Caucasians, and only 8 percent 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, says Sarkar. Further studies are needed to understand the reasons for such a discrepancy in liver-related mortality among these racial groups.

Reference: Sarkar M, et al. Lower Liver-Related Death in African American Women with HIV/HCV Co-Infection Compared to Caucasian and Hispanic Women. Hepatology; (DOI: 10.1002/hep.25859); November 2012.