Black patients with chronic hepatitis C have a lower sustained viral response rate than non-Blacks with genotype 1, but the same with genotypes 2/3, and this is not explained by more frequent dose reductions of interferon and ribavirin

N. Bräu, E. J. Bini, S. Currie, H. Shen, W. N. Schmidt, P. D. King, S. B. Ho, R. C. Cheung, K. Q. Hu, B. S. Anand, F. R. Simon, A. Aytaman, D. P. Johnson, J. A. Awad, J. Ahmad, C. L. Mendenhall, M. C. Pedrosa, R. H. Moseley, C. H. Hagedorn, B. WatersK. M. Chang, T. R. Morgan, S. J. Rossi, L. J. Jeffers, T. L. Wright

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34 Scopus citations

Abstract

In previous hepatitis C virus (HCV) treatment studies, Black patients not only had a lower sustained viral response (SVR) rate to interferon and ribavirin (RBV) than non-Black patients but also a higher frequency of HCV genotype 1 (GT-1) infection. The aim of this community-based study was to determine whether Black patients have a lower SVR rate independent of genotype. We prospectively enrolled 785 patients (24.8% Black, 71.5% White, 3.7% others) who received interferon alpha-2b 3 MU three times weekly + RBV 1000-1200 mg/day for 24 weeks (GT-2/3) or 48 weeks (GT-1). Black patients were more commonly infected with GT-1 (86.8%vs 64.8%, P < 0.001) and less frequently had an SVR compared with non-Black patients (8.4%vs 21.6%, P < 0.001). Within GT-1, Black patients had a lower SVR rate than non-Black patients (6.1%vs 14.1%, P = 0.004) but not within GT-2/3 (50.0%vs 36.5%, P = 0.47). Black patients had lower baseline haemoglobin levels (14.8 vs 15.3 g/dL, P < 0.001) and neutrophil counts (2900 vs 4100/mm3, P < 0.001) and required more frequent dose reductions of RBV (29.8%vs 18.5%, P < 0.001) and interferon (4.7%vs 1.6%, P = 0.012). However, dose reductions were not associated with lower SVR rates while early treatment discontinuations were (2.9%vs 25.7%, P < 0.001). Independent predictors of SVR were GT-1 [odds ratio (OR) 0.33; 95% confidence interval (CI) 0.20-0.55; P < 0.001], Black race (OR 0.45; 95% CI 0.22-0.93; P = 0.030), and advanced fibrosis, stages 3 + 4 (OR 0.53; 95% CI 0.31-0.92; P = 0.023). In conclusion, Black patients infected with HCV GT-1 (but not GT-2/3) have a lower SVR rate than non-Black patients. This is not explained by their lower baseline haemoglobin levels and neutrophil counts that lead to higher rates of ribavirin and interferon dose reductions.

Original languageEnglish (US)
Pages (from-to)242-249
Number of pages8
JournalJournal of viral hepatitis
Volume13
Issue number4
DOIs
StatePublished - Apr 2006

Keywords

  • Community-based practice
  • Dose reduction
  • Hepatitis C
  • Racial differences
  • Therapy

ASJC Scopus subject areas

  • Hepatology
  • Virology

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    Bräu, N., Bini, E. J., Currie, S., Shen, H., Schmidt, W. N., King, P. D., Ho, S. B., Cheung, R. C., Hu, K. Q., Anand, B. S., Simon, F. R., Aytaman, A., Johnson, D. P., Awad, J. A., Ahmad, J., Mendenhall, C. L., Pedrosa, M. C., Moseley, R. H., Hagedorn, C. H., ... Wright, T. L. (2006). Black patients with chronic hepatitis C have a lower sustained viral response rate than non-Blacks with genotype 1, but the same with genotypes 2/3, and this is not explained by more frequent dose reductions of interferon and ribavirin. Journal of viral hepatitis, 13(4), 242-249. https://doi.org/10.1111/j.1365-2893.2005.00682.x