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Hepatitis B and C in African Americans: Current Status and Continued Challenges

  • Kimberly A. Forde
    Affiliations
    Division of Gastroenterology and Hepatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

    Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Orapin Tanapanpanit
    Affiliations
    Division of Gastroenterology and Hepatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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  • K. Rajender Reddy
    Correspondence
    Reprint requests Address requests for reprints to: K. Rajender Reddy, MD, Professor of Medicine, Director of Hepatology, Perelman School of Medicine at the University of Pennsylvania, Division of Gastroenterology and Hepatology, 3400 Spruce Street, 2 Dulles, Philadelphia, Pennsylvania 19104. fax: (215) 615-1601.
    Affiliations
    Division of Gastroenterology and Hepatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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      Viral hepatitis remains a public health concern in the United States, resulting in excess morbidity and mortality for the individual and representing a burden to societies as evidenced by billions of dollars in health care expenditures. As with many chronic diseases, race and ethnicity influence various aspects of disease pathogenesis, including mechanisms of persistence, disease progression, disease sequelae, and response to therapy. For hepatitis B and C infections, African Americans disproportionately bear a large burden of disease in the United States. The role and importance of African American race, however, have been less well-characterized in the literature among the population of viral hepatitis–infected individuals. The differences in epidemiology, manifestations of liver disease, response to therapy, and differential trends in liver transplantation in African Americans compared with other racial and ethnic groups deserve special attention. This review will address the current status of hepatitis B and C infection in African Americans in the United States and identify some of the remaining challenges in diagnosis, characterization of natural history, and treatment. For the purposes of this review, the terms African American and black will be used interchangeably throughout the text.

      Keywords

      Abbreviations used in this paper:

      HBeAg (hepatitis B e antigen), HBsAg (hepatitis B surface antigen), HBV (hepatitis B virus), HCC (hepatocellular carcinoma), HCV (hepatitis C virus), IFN (interferon), IL (interleukin), MELD (Model for End-Stage Liver Disease), NHANES (National Health and Nutrition Examination Survey), PEG-IFN (peginterferon), RBV (ribavirin), SNP (single nucleotide polymorphism), SVR (sustained virologic response)
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