Demographics of a large cohort of urban chronic hepatitis C patients

PURPOSE: Recent studies suggest that African Americans (AA) with chronic hepatitis C (CHC) differ from non-Hispanic whites (NHW) with respect to the natural history and mortality resulting from the complications of chronic liver disease. The aim of this study was to examine the demographics of a large cohort of CHC patients and identify potential differences between AA and NHW. METHODS: This is a retrospective analysis, consisting of 2,739 hepatitis C antibody-positive patients seen at Wayne State University between 1995 and 2005. Patient demographics, risk factors, comorbidities, alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum hepatitis C (HCV) RNA levels, genotype, and liver biopsy results were recorded. RESULTS: AA constituted 75.4%, NHW 22.5%, and Asians or Hispanics 2.1% of the patients. Males predominated (58%), and the mean age of AA and NHW was 50.0 and 45.3 years, respectively (P ≤ 0.001). The most common risk factor was injection drug use in 55.3% (AA 57.1% vs. NHW 49.7%; P ≤ 0.002). HCV RNA by PCR obtained in 2,407 patients was positive in 94.8%, with a high viral load in 61%. Genotype 1 was significantly more frequent in AA (92.6%) than in NHW (70.6%, P ≤ 0.001). AA had lower median ALT levels (P ≤ 0.001). In those patients who were biopsied, there was no significant difference in fibrosis between the two groups. Aspartate to platelet index calculated in those patients who were not biopsied showed significantly lower fibrosis scores in AA. CONCLUSIONS: In this large cohort of CHC patients from a single institution, AA were older at presentation, had a higher prevalence of genotype 1, but significantly lower ALT levels than NHW.