S2085 Non-Invasive Hepatic Fibrosis Assay Scores Increase with Increasing Age in Patients with Chronic Hepatitis C

Purpose:Patients with Chronic Hepatitis C (CHC) may develop fulminant hepatitis if coinfected with Hepatitis A virus (HAV) or Hepatitis B virus (HBV). We sought to determine if our African-American (AA) and Hispanic population with CHC were tested and vaccinated as per AASLD guidelines. We also studied immunity patterns in HIV co-infected patients. Methods:We conducted a retrospective study at our university affiliated community health care center involving CHC patients seen in the hepatitis clinic from January 2004 to December 2007. Data on demographics, HIV status, HAV and HBV serology and vaccination was recorded. Patients with decompensated liver disease, acute HAV and active HBV were excluded. Results:Among 174 patients with CHC, 131 (75.2%) were Hispanics and 38 (21.8%) were AA. The prevalence of HAV immunity was higher than that of HBV (65% vs.40%,p 0.05). AA subjects were more likely to be tested for HAV and HBV immunity compared to Hispanics (76% vs. 59% p=NS; 92% vs. 82% p=NS respectively), though this difference did not reach statistical significance. Among 28 subjects co-infected with HIV (16%, n=174), the likelihood of being tested for immunity to HAV was higher than non-HIV subjects (93% vs. 61% p<0.0001). The prevalence of immunity to HAV or HBV did not differ in the two groups (p=NS). Conclusion:Among AA and Hispanics with CHC, we found a significantly higher prevalence of immunity to HAV than previously reported. Interestingly, immunity to HAV was higher than that to HBV. There is a disparity in the practice of testing for immunity to HAV compared to HBV. Despite established AASLD vaccination guidelines, HAV and HBV vaccination rates are yet sub-optimal. Increased physician awareness is necessary to ensure implementation of AASLD vaccination guidelines for HAV and HBV in minority patients with Chronic hepatitis C.