The prevalence of HCV infection is higher in the AA population in comparison with Caucasians and Hispanics. The majority of AAs are infected with genotype 1 and have a high viral load. There is a decreased ability to clear the virus after an acute attack, and the frequency on chronic infection is increased. The rate of progression to cirrhosis is lower in AAs, but once they become cirrhotic, their chance of developing HCC is higher. The AA population has been under-represented in clinical trials, and the initial observation pointing toward a lower SVR arising even from small studies has been confirmed, including studies using the current therapy of PEGIFN plus ribavirin. The use of WBD regimens of ribavirin is promising in the treatment of chronic hepatitis C in AAs.
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