# An investigation into how hepatitis C status affects fibrosis stage and progression among Alaska Native people with non-alcoholic fatty liver disease

> **NIH NIH P20** · ALASKA NATIVE TRIBAL HEALTH CONSORTIUM · 2024 · $45,998

## Abstract

PROJECT SUMMARY/ABSTRACT – Research Project 1: “An investigation into how hepatitis C status
affects fibrosis stage and progression among Alaska Native people with non-alcoholic fatty liver
disease”
Chronic liver disease and cirrhosis (CLD) is the sixth leading cause of death among Alaska Native (AN)
people. Between 2014 and 2018 the CLD mortality rate among AN people was 3.1 times the CLD mortality rate
for the U.S. all races population. The two most common types of CLD in the U.S. are fatty liver disease and
hepatitis C. The co-occurrence of hepatitis C virus (HCV) and fatty liver is associated with more rapid
progression to liver fibrosis and hepatocellular carcinoma (HCC) and results in worse outcomes than either
condition alone. We will assemble a cohort of AN people diagnosed with non-alcoholic fatty liver disease
(NAFLD), including AN people with and without a current or previous diagnosis of HCV, to determine how
infection with HCV modifies liver fibrosis, liver disease risk markers, and liver-related health outcomes among
AN people with NAFLD.
Aim 1: Assemble a well-characterized cohort of AN people with NAFLD to investigate differences in clinical
characteristics, risk factors, self-reported symptoms, and liver-related outcomes based on HCV status. We will
stratify participants by HCV status for comparisons of baseline clinical characteristics, risk factors, self-reported
symptoms, and liver-related outcomes including liver cancer and liver failure.
Aim 2: Compare fibrosis stage and progression by HCV status among AN people with NAFLD. Fibrosis increases
the risk of liver failure and creates a permissive environment for liver cancer. We will use vibration-controlled
transient elastography (VCTE) to measure the presence and amount of liver fibrosis at time of study enrollment.
We will also evaluate annualized change in fibrosis using available historic VCTE measurements. We will stratify
on HCV status to compare VCTE measurements at time of enrollment as well as annualized rates of change.
We will also investigate associations between these measures and clinical characteristics, risk factors, self-
reported symptoms, and liver-related outcomes.
The long-term goal for this research program is to reduce the burden of disease among AN people with NAFLD
by improving secondary prevention of adverse liver-related outcomes. A critical barrier to preventing these
adverse outcomes is knowing which AN people with NAFLD are most likely to progress to advanced fibrosis or
cirrhosis. This initial project focuses on the interaction between NAFLD and HCV in AN people. Better
understanding the interaction between NAFLD and HCV is crucial because they are the two most common types
of chronic liver disease in the U.S. and the two leading indicators for liver transplant. Furthermore, recent studies
suggest that NAFDL and HCV may have an additive or synergistic effect on liver injury.

## Key facts

- **NIH application ID:** 10770962
- **Project number:** 1P20GM152302-01
- **Recipient organization:** ALASKA NATIVE TRIBAL HEALTH CONSORTIUM
- **Principal Investigator:** Janet Marie Johnston
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $45,998
- **Award type:** 1
- **Project period:** 2024-05-01 → 2029-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10770962

## Citation

> US National Institutes of Health, RePORTER application 10770962, An investigation into how hepatitis C status affects fibrosis stage and progression among Alaska Native people with non-alcoholic fatty liver disease (1P20GM152302-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10770962. Licensed CC0.

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