التفاصيل البيبلوغرافية
| العنوان: |
Fibrosis Progression in African Americans and Caucasian Americans With Chronic Hepatitis C. |
| المؤلفون: |
Terrault, Norah A., Im, Kelly, Boylan, Ross, Bacchetti, Peter, Kleiner, David E., Fontana, Robert J., Hoofnagle, Jay H., Belle, Steven H. |
| المصدر: |
Clinical Gastroenterology & Hepatology; Dec2008, Vol. 6 Issue 12, p1403-1411, 9p |
| مصطلحات موضوعية: |
HEPATITIS C, DISEASES in African Americans, CAUCASIAN race, FIBROSIS, CHRONIC diseases, MARKOV processes, MEDICAL care research, PATIENTS, DISEASES |
| مستخلص: |
Background & Aims: Prior studies suggest the rate of liver fibrosis progression is slower in African Americans (AAs) than Caucasian Americans (CAs) with chronic HCV infection. Methods: With a multi-state Markov model, fibrosis progression was evaluated in a well-characterized cohort of 143 AA and 157 CA adults with untreated chronic HCV genotype 1 infection. In subjects with a history of injection drug use, duration of infection was imputed from a fitted risk model rather than assumed to be the reported first year of use. Results: The distribution of Ishak fibrosis stages was 0 (8.7%), 1/2 (55.7%), 3/4 (29.3%), and 5/6 (6.3%) and was similar in AAs and CAs (P = .22). After adjusting for biopsy adequacy, AAs had a 10% lower rate of fibrosis progression than did CAs, but the difference was not statistically significant (hazard ratio, 0.90; 95% confidence interval, 0.72–1.12). The overall 20-year estimates of probabilities of progression from stage 0 to stages 1/2, 3/4, and 5/6 were 59.3%, 28.8%, and 4.7%, respectively. The estimated median time from no fibrosis to cirrhosis was 79 years for the entire cohort and 74 and 83 years for CAs and AAs, respectively. In 3-variable models including race and biopsy adequacy, the factors significantly associated with fibrosis progression were age when infected, steatosis, ALT level, and necroinflammatory score. Conclusions: The rates of fibrosis progression were slow and did not appear to differ substantially between AAs and CAs. [Copyright &y& Elsevier] |
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