Racial differences seen in severity of cirrhosis

NEW YORK (Reuters Health) - African Americans and Hispanics with primary biliary cirrhosis -- a rare form of cirrhosis characterized by the destruction of small bile ducts in the liver -- often present with more severe disease than their Caucasian counterparts, results of a study suggest.

Primary biliary cirrhosis, or PBC, is an uncommon chronic liver disease that primarily afflicts young and middle-aged Caucasian women; there are limited data on non-Caucasian patients with this disease, Dr. Marion G. Peters, of the University of California, San Francisco, and colleagues note.

They analyzed information on 535 individuals with PBC being screened for a clinical trial. Of these, 462 were Caucasian, 21 were African American, 42 were Hispanic, and 10 were from other racial and ethnic groups.

The team found that non-Caucasians were significantly more likely than Caucasians to be deemed ineligible to participate in the clinical trial (46.6 percent versus 25.1 percent). This was mainly due to greater disease severity observed in non-Caucasians.

They also found that African Americans and Hispanics were much more likely than Caucasians to have a lower activity level, severe or difficult-to-control pruritus (chronic itching), and more advanced disease.

The reasons why biliary cirrhosis is more severe in non-Caucasian patients are unclear, the researchers note. "It is not clear whether these patients had more rapid disease, less access to care early in their disease, or misdiagnoses due to inadequate testing, the absence of liver biopsies, or the presence of (other illnesses) that may have led to a delay in treatment," the investigators explain.

SOURCE: Hepatology September 2007.