BACKGROUND: There is little published information on baseline characteristics and therapeutic outcomes in hepatitis C virus (HCV)-infected Aboriginal Canadians. It is unclear what proportion of HCV-infected Aboriginal people receive therapy relative to other populations. METHODS: Adults with chronic HCV infection, quantifiable serum HCV-RNA levels and compensated liver disease were assigned, at the physician's discretion, to either 24 or 48 weeks of treatment with peginterferon alpha-2a 180 mug/week plus ribavirin at a dose of 800 mg/day, or 1000 mg/day or 1200 mg/day in an open-label, expanded access program. The primary outcome was sustained virological response, defined as undetectable HCV-RNA by qualitative polymerase chain reaction (less than 50 IU/mL) at the end of 24 weeks of untreated follow-up. Baseline characteristics and outcomes in Aboriginal and non-Aboriginal patients were compared. RESULTS: A total of 2614 patients were eligible for the analysis; 44 individuals (1.7%) self-identified as being of Aboriginal heritage. The baseline characteristics of these two groups were similar. An overall sustained virological response was achieved in 47.7% and 46.5% of Aboriginal and non-Aboriginal patients, respectively. The overall frequencies of adverse events and laboratory abnormalities were similar between the two groups, although cytopenias occurred less frequently in Aboriginal patients. INTERPRETATION: Aboriginal patients were greatly under-represented in the present 'community'-based treatment program, yet viral responses were similar to those of a non-Aboriginal cohort. To increase the uptake of HCV therapy in the Aboriginal population, clarification of the obstacles to treatment is warranted.
BACKGROUND: There is little published information on baseline characteristics and therapeutic outcomes in hepatitis C virus (HCV)-infected Aboriginal Canadians. It is unclear what proportion of HCV-infected Aboriginalpeople receive therapy relative to other populations. METHODS: Adults with chronic HCV infection, quantifiable serum HCV-RNA levels and compensated liver disease were assigned, at the physician's discretion, to either 24 or 48 weeks of treatment with peginterferon alpha-2a 180 mug/week plus ribavirin at a dose of 800 mg/day, or 1000 mg/day or 1200 mg/day in an open-label, expanded access program. The primary outcome was sustained virological response, defined as undetectable HCV-RNA by qualitative polymerase chain reaction (less than 50 IU/mL) at the end of 24 weeks of untreated follow-up. Baseline characteristics and outcomes in Aboriginal and non-Aboriginal patients were compared. RESULTS: A total of 2614 patients were eligible for the analysis; 44 individuals (1.7%) self-identified as being of Aboriginal heritage. The baseline characteristics of these two groups were similar. An overall sustained virological response was achieved in 47.7% and 46.5% of Aboriginal and non-Aboriginal patients, respectively. The overall frequencies of adverse events and laboratory abnormalities were similar between the two groups, although cytopenias occurred less frequently in Aboriginal patients. INTERPRETATION: Aboriginal patients were greatly under-represented in the present 'community'-based treatment program, yet viral responses were similar to those of a non-Aboriginal cohort. To increase the uptake of HCV therapy in the Aboriginal population, clarification of the obstacles to treatment is warranted.
Authors: M P Manns; J G McHutchison; S C Gordon; V K Rustgi; M Shiffman; R Reindollar; Z D Goodman; K Koury; M Ling; J K Albrecht Journal: Lancet Date: 2001-09-22 Impact factor: 79.321
Authors: Jennifer E Layden-Almer; Ruy M Ribeiro; Thelma Wiley; Alan S Perelson; Thomas J Layden Journal: Hepatology Date: 2003-06 Impact factor: 17.425
Authors: Jordan J Feld; Santosh Nanda; Ying Huang; Weiping Chen; Maggie Cam; Susan N Pusek; Lisa M Schweigler; Dickens Theodore; Steven L Zacks; T Jake Liang; Michael W Fried Journal: Hepatology Date: 2007-11 Impact factor: 17.425
Authors: Stephanos J Hadziyannis; Hoel Sette; Timothy R Morgan; Vijayan Balan; Moises Diago; Patrick Marcellin; Giuliano Ramadori; Henry Bodenheimer; David Bernstein; Mario Rizzetto; Stefan Zeuzem; Paul J Pockros; Amy Lin; Andrew M Ackrill Journal: Ann Intern Med Date: 2004-03-02 Impact factor: 25.391
Authors: Jennifer E Layden-Almer; Carla Kuiken; Ruy M Ribeiro; Kevin J Kunstman; Alan S Perelson; Thomas J Layden; Steven M Wolinsky Journal: J Infect Dis Date: 2005-08-12 Impact factor: 5.226
Authors: Gerald Y Minuk; Meaghan O'Brien; Kim Hawkins; Didi Emokpare; James McHattie; Paul Harris; Lawrence Worobetz; Karen Doucette; Kelly Kaita; Stephen Wong; Gilles Pinette; Julia Uhanova Journal: Can J Gastroenterol Date: 2013-12 Impact factor: 3.522
Authors: Patricia M Spittal; Margo E Pearce; Negar Chavoshi; Wayne M Christian; Akm Moniruzzaman; Mary Teegee; Martin T Schechter Journal: BMC Public Health Date: 2012-08-09 Impact factor: 3.295
Authors: Nasheed Moqueet; Claire Infante-Rivard; Robert W Platt; Jim Young; Curtis Cooper; Mark Hull; Sharon Walmsley; Marina B Klein Journal: Int J Mol Sci Date: 2015-03-20 Impact factor: 5.923
Authors: Jorge Mera; Kartik Joshi; Karla Thornton; Terry Box; John Scott; Miranda Sedillo; Paulina Deming; Crystal David; Whitney Essex; Richard Manch; Anita Kohli Journal: Open Forum Infect Dis Date: 2019-07-04 Impact factor: 3.835
Authors: Stephen E Livingston; Lisa J Townshend-Bulson; Dana J T Bruden; Chriss E Homan; James E Gove; Julia N Plotnik; Brenna C Simons; Philip R Spradling; Brian J McMahon Journal: Int J Circumpolar Health Date: 2016-03-29 Impact factor: 1.228