Chronic hepatitis C in African Americans and other minority groups.

Chronic hepatitis C virus (HCV) is the most common bloodborne infection in the United States. An estimated 2.7 million Americans are infected, with the greatest prevalence of infection in African Americans at 3.2%. African Americans account for 22% of Americans with HCV. Recent studies have shown that African Americans are less likely to have cirrhosis than similarly infected non-Hispanic white patients and are more likely to have genotype 1 infection and to develop hepatocellular carcinoma. Several studies have shown that the response rates of African Americans to interferon and ribavirin are significantly lower than those for non-Hispanic whites. Despite the relatively low percentage of African-American patients in these early studies, similar preliminary results are being found in larger prospective studies with the newer treatment regimens of pegylated interferon and ribavirin. Differences in immunologic status, viral kinetics, and iron studies have also been found in HCV-infected African-American patients. Less is known about Mexican Americans and other minority groups because they are poorly represented in clinical trials. Efforts at increasing racial diversity in clinical trials are ongoing.