(13 Total References)
Medical Director, Liver Transplantation
University of Illinois at Chicago
AMNews: Dec. 3, 2001. Physicians focus on hepatitis among African-Americans ... American Medical News
"Vaccination with A and B needs to be done, but they're not nearly a big a problem as hep C," said Thelma Wiley, MD, director of liver transplantation at the University of Illinois at Chicago College of Medicine.
Meanwhile, hepatitis C prevention efforts are complicated.First, there is no vaccine.Also, though other variants cause symptoms, this one rarely does -- making compliance with treatment, which frequently makes a patient feel ill, very challenging.
"Cost is an issue, but mostly it's the side effects.
"There's a lot of mistrust on the part of African-American patients that the medical community has earned when it comes to medical research, but we need to move past that," Dr. Wiley
said."But there are also socioeconomic reasons.When people are worried about where they're going to get their next meal, they're going to be less inclined to participate in a study that is going to require them to come back and forth."
Experts generally praised the NMA's efforts with only one caveat.
"Who's going to pay for all these vaccinations?"
In addition, Dr. Thelma Wiley, medical director for Liver Transplantation at Rush, is leading a large hepatitis C study, sponsored by the National Institutes of Health, that will provide free medication, lab work and medical care to participants.This is especially important, according to Dr. Wiley, for chronic hepatitis C patients who do not have health insurance.
Thelma Wiley, Medical director, Liver Transplantation, Univ. of Ill. at Chicago, 2001
While African-Americans have twice the ...
While African-Americans have twice the rate of [ hepatitis C virus ] infection and are more frequently infected with genotype 1 virus , the natural history of this disease and its histologic progression have not been reported previously , said primary investigator Thelma E. Wiley , MD , medical director of the liver transplantation unit at the Digestive Diseases and Liver Center , University of Illinois at Chicago Medical Center ( UICMC ).
Thus , Dr. Wiley
colleagues at UICMC set out to determine the natural history of HCV in this population.
The team reviewed the charts of 438 study participants who were HCV-RNA-positive.They analyzed demographic , virologic , biochemical and histologic data , including age , gender , race , weight , alcohol intake–defined as any history of alcohol use , even mild to moderate intake–baseline alanine aminotransferase ( ALT ) , and mode and duration of infection.
Liver biopsies that had been previously performed were re-read by a blinded hepatologist.
There were 112 African-Americans and 243 Americans of other races included in the patients studied.
In the second and third decade of infection , African-Americans had significantly lower PMN compared to non-African-Americans , Dr. Wiley
said.But while the degree of fibrosis increased over the four decades of exposure [ to HCV ] in both populations , the African-Americans had significantly less fibrosis and cirrhosis in the third and fourth decades..
By the fourth decade of HCV infection , 51 % of non-African-Americans in the study had cirrhosis , while only 22 % of African-Americans were cirrhotic.
We found that the rate of fibrosis progression was slower in African-Americans , resulting in a lower rate of cirrhosis , said Dr. Wiley
.All of our data together suggest that African-Americans may lack immune recognition of HCV-infected liver cells..
–Rosemary Frei , MSc
This article is derived from the McMahon Archives.This information may be time sensitive and was archived on 8/31/2000.