Viral hepatitis and hepatocellular carcinoma in African Americans.

Introduction HCC is the eighth most common cancer worldwide. It is a diagnosis with very poor prognosis, causing about 1 million deaths each year. Chronic infection with HBV and HCV is a major risk factor for HCC. For patients with active chronic hepatitis B, there is a 10– 100-fold increase in the risk of hepatocellular cancer. Unlike many other forms of chronic liver diseases, hepatitis B can cause hepatocellular cancer in the absence of cirrhosis. Because recurrent inflammation is the major culprit in these cases, efforts geared toward the reduction of inflammation should be offered to all patients. Although hepatitis B is more prevalent among African Americans than Caucasian Americans, few trials have examined the response of African Americans to currently available therapies. Hepatitis C is one of the most common chronic bloodborne viral infections in the United States. Recurrent bouts of inflammation lead to progressive fibrosis, cirrhosis, and HCC in some patients. Although enormous strides have been made in the treatment of chronic hepatitis C infection over the last two decades, lesser gains have accrued in the management of African Americans with this disease. African-American men have the highest rate of infection among groups in the United States; they also have lower rates of response to treatment in comparison with Caucasians. This poor response to treatment for hepatitis C among African Americans is not well understood, and studies on the efficacy of antiviral medications have included only a few African-American participants.