Racial differences in liver inflammation and fibrosis related to chronic hepatitis C

Kester Crosse, Onuora G. Umeadi, Frank A. Anania, Jacqueline Laurin, John Papadimitriou, Cinthia Drachenberg, Charles D. Howell

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


Background & Aims: Hepatitis C virus (HCV) infection is more prevalent in black compared with white Americans. However, the natural course of HCV in black patients has not been defined. Methods: We performed a retrospective comparison of initial liver tests, HCV genotype and viral load, and liver histology findings in 87 black and 136 white American chronic hepatitis C patients who were evaluated at the University of Maryland between 1995 and 1998. The liver biopsy examinations were interpreted by using the Knodell Histologic Activity Index (HAI) criteria. Results: Black HCV patients were older (46.3 vs. 43.3 yr; P = 0.004) and were more likely to be infected with HCV genotype 1 (95% vs. 75%). The modes of HCV transmission, estimated duration of HCV infection, and prevalence of alcohol abuse were similar in the 2 groups. Yet, black patients had lower mean total HAI scores (7.6 vs. 8.7; P = 0.021), periportal hepatocyte necrosis scores (P = 0.021), and liver fibrosis scores (P = 0.049). In keeping with less hepatic necroinflammatory activity, black patients had a lower mean serum alanine transaminase (ALT) level (85.5 vs. 122.7; P = 0.002). Black patients also had lower serum iron levels (P = 0.009). There were no racial differences in the prevalence of increased iron studies and hepatic iron loading. Conclusions: Black chronic HCV patients have milder liver necroinflammation and fibrosis than white patients with similar HCV duration. These differences in liver histology were not explained by a variance in hepatic iron loading.

Original languageEnglish (US)
Pages (from-to)463-468
Number of pages6
JournalClinical Gastroenterology and Hepatology
Issue number6
StatePublished - Jun 2004
Externally publishedYes


  • HAI
  • histology activity index

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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