Racial disparity in liver disease: Biological, cultural, or socioeconomic factors

Abstract

Chronic liver diseases are a major public health issue in the United States, and there are substantial racial disparities in liver cirrhosis-related mortality. Hepatitis C virus (HCV) is the most significant contributing factor in the development of chronic liver disease, complications such as hepatocellular carcinoma, and the need for liver transplantation. In the United States, African Americans have twice the prevalence of HCV seropositivity and develop hepatocellular carcinoma at more than twice the rate as whites. African Americans are, however, less likely to respond to interferon therapy for HCV than are whites and have considerably lower likelihood of receiving liver transplantation, the only definitive therapy for end-stage liver disease. Even among those who undergo transplantation, African Americans have lower 2-year and 5-year graft and patient survival compared to whites. We will review these racial disparities in chronic liver diseases and discuss potential biological, socioeconomic, and cultural contributions. An understanding of their underlying mechanisms is an essential step in implementing measures to mollify racially based inequities in the burden and management of liver disease in an increasingly racially and ethnically diverse population. (HEPATOLOGY 2008;47:1058-1066

Assessment of Specific Antibodies to F Protein in Serum Samples from Chinese Hepatitis C Patients Treated with Interferon plus Ribavarin

“…Previous studies have shown that the geographical distribution of HCV genotypes may have epidemiological relevance and clinical implications, such as response to therapy and disease progression (13). In addition, racial disparities might influence how HCV infection behaves, causing differences in the prevalence of HCV infection, clinical presentation, treatment response, and immunological recognition of HCV (18). It is deduced that these factors might have some impact on the characteristics of HCV anti-F antibody activity.…”

Functional magnetic resonance imaging monitoring of pathological changes in rodent livers during hyperoxia and hypercapnia†

“…Coronal and axial T 1 -weighted spin echo images of the whole liver were acquired for alignment and to determine liver volume (repetition time ϭ 500 ms; echo time ϭ 18 ms). 2 (95% air and 5% CO 2 ), and oxygen-CO 2 (95% oxygen and 5% CO 2 ) as described. 19,24 Five repeats were acquired at each gas mixture.…”

“…1,2 Evaluation of the level of liver pathological changes, such as cirrhosis, regeneration, or cancer, is important from both the diagnostic and the therapeutic aspects. Currently, there are limited tools for noninvasively monitoring these pathological alterations in the liver.…”

Type 2 diabetes and risk of hospital admission or death for chronic liver diseases

“…However, it is not known whether SES influences the association between T2DM and CLDs, as it does for T2DM and cardiovascular disease [15]. The need for further research on the contribution of SES to disparities in incidence, treatment and outcomes of liver disease has previously been identified [16,17].…”