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Hispanic Veterans with HCV at Increased Risk for Cirrhosis, HCC

Hispanic veterans with hepatitis C virus infection had a higher risk for developing cirrhosis or hepatocellular carcinoma compared with African-American and non-Hispanic white patients, according to new study results.

Researchers, including Hashem B. El-Serag, MD, MSHS, and Fasiha Kanwal, MD, MSHS, of Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, collected and analyzed data from 149,407 patients (mean age, 52.5 years) in the Veterans Administration HCV Clinical Case Registry database between 2000 and 2009. All patients had active hepatitis C virus (HCV) viremia; 56.3% were non-Hispanic whites, 36.1% were African-Americans, 6% were Hispanic, and 1.6% were of other races.

Hashem B. El-Serag

Data showed that Hispanics has the highest annual incidence rates of hepatocellular carcinoma (HCC; 7.8%) and cirrhosis (28.8%) among 3,551 and 13,099 patients who developed HCC and cirrhosis, respectively, during a mean follow-up of 5.2 years. African-Americans had the lowest incidence rates (3.9%, HCC; 13.3%, cirrhosis) compared with non-Hispanic whites (4.7% and 21.6%). Hispanics with HCV also had a greater risk for having a recorded diagnosis of cirrhosis (adjusted HR=1.28; 95% CI, 1.21-1.37) and HCC (aHR=1.61; 95% CI, 1.44-1.8) compared with non-Hispanic whites, while the risk among African-Americans was lower for cirrhosis (aHR=0.58; 95% CI, 0.55-0.6) and HCC (aHR=0.77; 95% CI, 0.71-0.83).

Fasiha Kanwal

Adjusting for HCV genotype, HCV treatment, diabetes, and other factors, there were no changes in the association of race between development of cirrhosis or HCC.

“Patients’ race was significantly associated with the risk for cirrhosis and HCC,” the researchers concluded. “These data are relevant to further the understanding of genetic as well as nongenetic differences that may explain the racial variations in the progression of liver disease, and can also guide physicians in counseling patients with HCV regarding the risk of disease progression.”

Disclosure: The researchers report no relevant financial disclosures.