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Race does not impact early mortality among patients with chronic HCV

Recent findings published in the Journal of Viral Hepatitis showed that race was a nonfactor in the early mortality of patients with hepatitis C virus infection. African-American patients with kidney disease and low albumin, however, were at greater risk for HCV-related mortality.

“All patients with chronic HCV regardless of race died at an earlier age (53-65 years) than predicted for the overall population (75-79 years),” Paul H. Naylor, PhD, assistant professor of internal medicine/gastroenterology at Wayne State University School of Medicine, and colleagues wrote. “[However], this is the first study to report racial disparity in comorbidities and that the increased HCV mortality in African-Americans has as a significant risk factor chronic kidney disease.”

In the United States, 3.2 million people are infected with HCV and are at risk for cirrhosis, liver failure and hepatocellular carcinoma, the researchers wrote. Many studies have demonstrated these poor outcomes for patients with HCV, but few studies have assessed the influence of race.

To determine whether race is a factor in HCV mortality, the researchers performed a retrospective study of 3,724 patients with HCV who were initially seen between 1995 and 2008. Patients with chronic HCV included 2,879 African-Americans, 758 whites and 87 who belonged to another race. The average time to death from first visit was 5 years, and the mean age at death was 55 years.

Naylor and colleagues determined that African-Americans (23%) were just as likely to have died from HCV as whites (22%). Increased mortality was associated with cirrhosis, fibrosis, low albumin, diabetes, renal impairment and cardiac symptoms. Both African-American and white patients who were treated and cleared the virus, however, had a mortality of 5% compared with 26% of treatment-naive African-American patients and 24% of untreated white patients.

The investigators noted that African-American patients with kidney disease and low albumin were at greater early mortality risk than whites with those characteristics.

“The data also suggest patients with cirrhosis must receive treatment as rapidly as possible,” Naylor and colleagues wrote. “Given that a significant number of individuals in the United States are just now being identified by screening protocols, rapid treatment as soon as possible before patients reach significant fibrosis is critical for preventing an early death due to their HCV infection.” – by Will Offit

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