Racial/Ethnic Differences in Spontaneous HCV Clearance in HIV Infected and Uninfected Women

Abstract

Background/Aims Among individuals without human immunodeficiency virus (HIV), African Americans have lower spontaneous clearance of hepatitis C virus (HCV) than Caucasians, and women have higher clearance than men. Few studies report racial/ethnic differences in acute HCV in HIV infected, or Hispanic women. We examined racial/ethnic differences in spontaneous HCV clearance in a population of HCV mono- and co-infected women. Methods We conducted a cross sectional study of HCV seropositive women (897 HIV infected and 168 HIV uninfected) followed in the US multicenter, NIH-funded Women's Interagency HIV Study (WIHS), to determine the association of race/ethnicity with spontaneous HCV clearance, as defined by undetectable HCV RNA at study entry. Results Among HIV and HCV seropositive women, 18.7 % were HCV RNA negative, 60.9 % were African American, 19.3 % Hispanic and 17.7 % Caucasian. HIV infected African American women were less likely to spontaneously clear HCV than Hispanic (OR 0.59, 95 % CI 0.38–0.93, p = 0.022) or Caucasian women (OR 0.57, 95 % CI 0.36–0.93, p = 0.023). Among HIV uninfected women, African Americans had less HCV clearance than Hispanics (OR 0.18, 95 % CI 0.07–0.48, p = 0.001) or Caucasians (OR 0.26, 95 % CI 0.09–0.79, p = 0.017). There were no significant differences in HCV clearance between Hispanics and Caucasians, among either HIV infected (OR 0.97, 95 % CI 0.57–1.66, p = 0.91) or uninfected (OR 1.45, 95 % CI 0.56–3.8, p = 0.45) women. Conclusions African Americans were less likely to spontaneously clear HCV than Hispanics or Caucasians, regardless of HIV status. No significant differences in spontaneous HCV clearance were observed between Caucasian and Hispanic women. Future studies incorporating IL28B genotype may further explain these observed racial/ethnic differences in spontaneous HCV clearance.

Marijuana Use Is Not Associated With Progression to Advanced Liver Fibrosis in HIV/Hepatitis C Virus–coinfected Women

“…The development of liver fibrosis can take years, and prolonged THC use may be required to change rates of liver fibrosis. Similar to other published studies, we found that presence of baseline fibrosis, entry CD4 count and HCV RNA level, and ongoing alcohol consumption were predictive of significant fibrosis in WIHS follow-up [27,28], whereas African American race was found to be protective [29,30].…”

Assessing hepatitis C spontaneous clearance and understanding associated factors—A systematic review and meta‐analysis

“…Forty‐three studies were included in the analysis of demographic, clinical and behavioural factors associated with HCV clearance, representing a total of 20 110 individuals. The following groups were significantly less likely than others to spontaneously clear HCV: males (OR = 0.68, 95% CI: 0.59‐0.81), those with asymptomatic infection (OR = 0.38, 95% CI: 0.27‐0.55), black race (OR = 0.38, 95% CI: 0.20‐0.75), older adults (age ≥45 years, OR = 0.52, 95% CI: 0.64‐0.97), those with HIV co‐infection (OR = 0.50, 95% CI: 0.37‐0.67), those without hepatitis B co‐infection (OR = 0.24, 95% CI: 0.19‐0.32), patients with nongenotype 1 infection (OR = 0.63, 95% CI: 0.45‐0.89), nonaboriginal groups (OR = 0.47, 95% CI: 0.36‐0.62), and those with excess alcohol use (OR = 0.67, 95% CI: 0.47‐0.95) and those with a history of injecting drug use (OR = 0.59, 95% CI: 0.37‐0.93).…”

Estimates of state-level chronic hepatitis C virus infection, stratified by race and sex, United States, 2010

“…State-level differences in incarceration rates by race might also track with local differences in HCV prevalence. Acute HCV clearance has been hypothesized to be lower in African Americans compared to Hispanic and white counterparts [ 33 – 35 ]. This is supported by viral clearance being lower in genotype 1 infections, which occur more frequently in African Americans.…”