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Related Concept Videos

Hepatitis01:25

Hepatitis

Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver. The...
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
Viral Hepatitis I: Introduction01:28

Viral Hepatitis I: Introduction

Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion of food...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
Hepatic Drug Excretion: Influencing Factors01:16

Hepatic Drug Excretion: Influencing Factors

The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...

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Racial differences in hepatitis C treatment eligibility.

Michael T Melia1, Andrew J Muir, Jonathan McCone

  • 1Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. mmelia4@jhmi.edu

Hepatology (Baltimore, Md.)
|April 14, 2011
PubMed
Summary

Black Americans face significant barriers to hepatitis C virus (HCV) treatment eligibility. Higher rates of neutropenia and uncontrolled conditions like diabetes limit access for Black patients.

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Published on: March 13, 2015

Area of Science:

  • Hepatology
  • Clinical Trials
  • Health Disparities

Background:

  • Black Americans experience disproportionately high rates of hepatitis C virus (HCV) infection.
  • Existing HCV treatments, peginterferon (PEG-IFN) plus ribavirin (RBV), show lower response rates in Black patients compared to White patients.

Purpose of the Study:

  • To investigate the impact of race on eligibility for HCV treatment.
  • To evaluate the rates and reasons for HCV treatment ineligibility among different racial groups.

Main Methods:

  • Retrospective analysis of a Phase 3B multicenter clinical trial involving 4,469 screened patients.
  • Data collected from 118 United States academic and community medical centers.
  • Evaluation of treatment ineligibility based on self-reported race.

Main Results:

  • 23.2% of screened patients were ineligible for HCV treatment.
  • Black patients were more likely to be ineligible for treatment (40.2%) than non-Black patients (28.5%).
  • After exclusions, Black patients were 65% less likely to be eligible for treatment compared to non-Black patients (17.0% vs 28.1%).
  • Higher prevalence of neutropenia, anemia, elevated glucose, and creatinine contributed to ineligibility in Black patients.

Conclusions:

  • Black patients face significant barriers to HCV treatment eligibility, primarily due to higher rates of neutropenia and uncontrolled medical conditions (diabetes, renal insufficiency).
  • Less conservative neutrophil count requirements and improved management of chronic diseases could enhance treatment access for Black patients.