Title: Hepatitis B in Aboriginal Populations in the Arctic: Alaska Natives, Canadian Inuit and First Nations Peoples, Greenland Inuits and Russian Native Populations - Progress update (pdf)
Summary of Activity
Although liver disease is the 12th leading cause of death in Americans, it is the 6th leading causing of death in American Indians and Alaska Natives. Similarly in Canada, deaths from liver disease are also the fifth leading cause of deaths in the 45-65 year age group. Chronic viral hepatitis due to hepatitis B and C are believed to be major contributors to liver disease in these populations. Greenland has one of the highest rates of HBV infection in the world and HBV and HCV are felt to be a major health problem in Russia, especially in remote populations. We propose to study the epidemiology of HBV in Aboriginal populations in the Arctic, the factors associated with disease progression, including demographic, environmental and viral factors and the impact of antiviral therapy in persons deemed suitable for treatment by established practice guidelines. The goals of this proposal are: 1. To determine the epidemiology of chronic HBV in Aboriginal Populations in the Arctic. 2. To monitor cohorts of HBV infected patients in these regions to determine the proportion who develop active liver disease by monitoring liver aminotransferase and HBV DNA levels on a regular basis and reviewing results of liver biopsies performed for clinical purposes. 3. To examine demographic factors associated with disease outcome. 4. To examine environmental factors associated with disease outcome including contaminants in the environment and food sources. 5. To examine the role of cofactors that might contribute to liver disease such as alcohol intake, obesity and the metabolic syndrome. 6. To examine viral characteristics in indigenous populations in the Arctic comparing HBV genotype distribution, viral loads and viral mutations that could be related to disease outcomes 7. By identifying potential treatment candidates and examining barriers to treatment and outcome of treatment including the role of factors such as demographic, viral genotype and environmental factors in response to treatment.
Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium and Arctic Investigations Program Centers for Disease Control and Prevention
4315 Diplomacy Drive
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