By Liz Highleyman

Compared to individuals of other racial/ethnic groups, Asian-Americans with chronic hepatitis C virus (HCV) infection are more likely to have no identifiable risk factors for contracting the disease, according to research presented by Edith Ho of Stanford University Medical Center and colleagues at the Digestive Disease Week (DDW 2009) annual meeting last week in Chicago.

HCV infection is most often associated with a history of blood transfusions, injection drug use (due to shared needles and other equipment), intranasal cocaine use (due to shared straws), tattoos, and multiple sexual partners, the researchers noted as background. A significant proportion of patients, however, have no known risk factors.

The investigators conducted a prospective study in which 494 hepatitis C patients seen at a Northern California liver center between 2001 and 2008 completed a detailed risk assessment questionnaire. Just over half (55%) identified themselves as Caucasian, 20% as Hispanic, and 25% as Asian-American.

Results

	Asian participants (59%) were significantly more likely to be foreign-born than Hispanics (30%) or Caucasians (19%).
	HCV genotype 1 was most common in all groups, at about 75%.
	4% of Caucasians, 7% of Hispanics, and 15% of Asian-Americans reported no known HCV risk factors such as blood transfusions, injection drug use, acupuncture, tattoos, or snorting cocaine.
	18% of Caucasians, 22% of Hispanics, and 45% of Asian-Americans reported 1 HCV transmission risk factor.
	78% of Caucasians, 71% of Hispanics, and 41% of Asian-Americans reported 2 or more transmission risk factors.
	Injection drug use, cocaine snorting, and tattoos were all significantly more likely to be reported by Caucasian and Hispanic patients compared with Asian-Americans.
	Asian-Americans, however, were significantly more likely to have received acupuncture.
	Of the Asian-Americans who reported 1 risk factor, this was acupuncture for 42%.

"Asian-Americans are more likely to present with unidentifiable risk exposures for HCV while Caucasians and Hispanics are more likely to present with multiple risk exposures," the investigators concluded. "Therefore, commonly known risk factors for HCV may be more appropriate for risk assessment of Caucasians and Hispanics, but not Asian-Americans."

These findings, they added, "pose major implications for developing strategies for HCV screening in our increasingly culturally diverse population."

Department of Internal Medicine, Stanford University Medical Center, Stanford, CA; Pacific Health Foundation, San Jose, CA.

6/12/09

Reference
EY Ho, NB Ha, H Mindie, and H Nguyen. Risk Factors for Hepatitis C Acquisition Are More Likely to Be Unidentifiable in Asian-Americans Compared to Caucasians or Hispanics (Prospective Study). Digestive Disease Week (DDW 2009). Chicago. May 30-June 4, 2009. Abstract M1779.