OBJECTIVE: The sustained virological response (SVR) to non-pegylated interferon-based regimens for chronic hepatitis-C virus (HCV) has been lower among African Americans compared to Caucasians, a finding attributed to the high proportion of genotype-1 infections in African Americans. To determine whether such a difference in SVR is still present with pegylated interferon and ribavirin regimens, we analyzed SVR rates among treated racial groups according to genotype. METHODS: Consecutive treatment-naïve patients of multiethnic and racial backgrounds attending a university liver clinic received either Peg alfa-2a or -2b plus ribavirin 1-1.2 g based on body weight for 24-48 weeks, depending on genotype. HCV RNA titers were analyzed at 0, six or 12 months, and six months posttreatment. RESULTS: Among the first 193 patients eligible for treatment, 73 received therapy [24 African Americans (genotype 1 in 88%); 49 non-African Americans (genotype 1 in 59%)]. Of the 120 patients not treated (33% African-American and 67% non-African-American), most either had mild hepatitis on biopsy, normal ALT values, an untreated psychiatric condition or had a low expectation of treatment efficacy. SVR results for the 73 patients who completed treatment indicate that African Americans and non-African Americans with genotype 1 have similarly low rates of SVR (19% in African Americans compared with 24% in non-African Americans, p=NS). CONCLUSION: Sustained viral response rates in our open-access liver clinic are similar for genotype-1 African Americans compared to non-African Americans receiving pegylated interferon and ribavirin. The predominance of genotype 1 among African-American patients likely accounts for the lower response rates, but genotype 1 in other racial groups is associated with a proportionately lower SVR as well as a risk for delayed relapse after SVR.
OBJECTIVE: The sustained virological response (SVR) to non-pegylated interferon-based regimens for chronic hepatitis-C virus (HCV) has been lower among African Americans compared to Caucasians, a finding attributed to the high proportion of genotype-1 infections in African Americans. To determine whether such a difference in SVR is still present with pegylated interferon and ribavirin regimens, we analyzed SVR rates among treated racial groups according to genotype. METHODS: Consecutive treatment-naïve patients of multiethnic and racial backgrounds attending a university liver clinic received either Peg alfa-2a or -2b plus ribavirin 1-1.2 g based on body weight for 24-48 weeks, depending on genotype. HCV RNA titers were analyzed at 0, six or 12 months, and six months posttreatment. RESULTS: Among the first 193 patients eligible for treatment, 73 received therapy [24 African Americans (genotype 1 in 88%); 49 non-African Americans (genotype 1 in 59%)]. Of the 120 patients not treated (33% African-American and 67% non-African-American), most either had mild hepatitis on biopsy, normal ALT values, an untreated psychiatric condition or had a low expectation of treatment efficacy. SVR results for the 73 patients who completed treatment indicate that African Americans and non-African Americans with genotype 1 have similarly low rates of SVR (19% in African Americans compared with 24% in non-African Americans, p=NS). CONCLUSION: Sustained viral response rates in our open-access liver clinic are similar for genotype-1 African Americans compared to non-African Americans receiving pegylated interferon and ribavirin. The predominance of genotype 1 among African-American patients likely accounts for the lower response rates, but genotype 1 in other racial groups is associated with a proportionately lower SVR as well as a risk for delayed relapse after SVR.
Authors: M J Alter; D Kruszon-Moran; O V Nainan; G M McQuillan; F Gao; L A Moyer; R A Kaslow; H S Margolis Journal: N Engl J Med Date: 1999-08-19 Impact factor: 91.245
Authors: C L Thio; D L Thomas; J J Goedert; D Vlahov; K E Nelson; M W Hilgartner; S J O'Brien; P Karacki; D Marti; J Astemborski; M Carrington Journal: J Infect Dis Date: 2001-05-30 Impact factor: 5.226
Authors: M Martinot-Peignoux; P Marcellin; M Pouteau; C Castelnau; N Boyer; M Poliquin; C Degott; I Descombes; V Le Breton; V Milotova Journal: Hepatology Date: 1995-10 Impact factor: 17.425
Authors: Raymond T Chung; Janet Andersen; Paul Volberding; Gregory K Robbins; Tun Liu; Kenneth E Sherman; Marion G Peters; Margaret J Koziel; Atul K Bhan; Beverly Alston; Dodi Colquhoun; Tom Nevin; George Harb; Charles van der Horst Journal: N Engl J Med Date: 2004-07-29 Impact factor: 91.245
Authors: K Bichoupan; J M Schwartz; V Martel-Laferriere; E R Giannattasio; K Marfo; J A Odin; L U Liu; T D Schiano; P Perumalswami; M Bansal; P J Gaglio; H Kalia; D T Dieterich; A D Branch; J F Reinus Journal: Aliment Pharmacol Ther Date: 2013-11-24 Impact factor: 8.171