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Progression to cirrhosis in Latinos with chronic hepatitis C: differences in Puerto Ricans with and without human immunodeficiency virus coinfection and along gender.

Abstract：

BACKGROUND:Hepatitis C virus (HCV) infection is prevalent in Latinos. There is some evidence that progression to cirrhosis is more rapid. END POINTS:To calculate time of cirrhosis from time of HCV infection in a large Latino population. Other end points were to assess variables that predict cirrhosis and the effect of gender, alcohol, and human immunodeficiency virus (HIV) infection status on time to cirrhosis. METHODS:Four hundred sixty-nine Latino patients evaluated at a referral center in Puerto Rico were included. Several demographic parameters, such as risk factors, estimated duration of HCV infection, alcohol use, HIV status, and findings from the usual HCV and HIV laboratory tests were noted. All patients had liver biopsy specimens assessed by Ishak score. RESULTS:Monoinfected and coinfected latinos have a median cumulative risk/hazard for cirrhosis of 42.0 vs. 32.0 years after infection (P = 0.0016). The median age of cirrhotic patients is 53.0 years in monoinfections and 42.0 years in coinfection. Among coinfected patients there is no gender-associated difference in time to onset of cirrhosis (P = 0.785). Among monoinfected patients, males have a shorter median risk/hazard to cirrhosis than females (11.0-year difference; P = 0.05) and have a shorter time until onset of cirrhosis by fibrosis progression rate (FPR) (33.33 vs. 41.66 years; P = 0.021). There is no difference between male patients with regard to HIV status (P = 0.199). Alcohol use is significant in monoinfected males (59.2 g/day) vs. females (11.4 g/day; P = 0.001). Variables that predict cirrhosis are male sex, age, and Ishak grade in monoinfected patients and alanine aminotransferase value in coinfected patients. CONCLUSIONS:Puerto Ricans with HCV have a median risk/hazard time to cirrhosis at younger age than other populations. Males who are HIV/HCV-coinfected have the same median risk/hazard and time to cirrhosis than those monoinfected with HCV. Special attention for early diagnosis and treatment is mandatory.

journal_name

J Clin Gastroenterol

journal_title

Journal of clinical gastroenterology

authors

Rodríguez-Torres M,Ríos-Bedoya CF,Rodríguez-Orengo J,Fernández-Carbia A,Marxuach-Cuétara AM,López-Torres A,Salgado-Mercado R,Bräu N

doi

10.1097/01.mcg.0000210105.66994.dc

subject

Has Abstract

pub_date

2006-04-01 00:00:00

pages

358-66

issue

eissn

0192-0790

issn

1539-2031

pii

00004836-200604000-00015

journal_volume

pub_type

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Progression to cirrhosis in Latinos with chronic hepatitis C: differences in Puerto Ricans with and without human immunodeficiency virus coinfection and along gender.