Peginterferon and Ribavirin Treatment in African American and Caucasian American Patients With Hepatitis C Genotype 1

Hari S. Conjeevaram, Michael W. Fried, Lennox J. Jeffers, Norah A. Terrault, Thelma E. Wiley-Lucas, Nezam Afdhal, Robert S. Brown, Steven H. Belle, Jay H. Hoofnagle, David E. Kleiner, Charles D. Howell

Research output: Contribution to journalArticle

422 Scopus citations

Abstract

Background & Aims: Compared with Caucasian Americans (CA), African Americans (AA) with chronic hepatitis C are less likely to respond to interferon-based antiviral therapy. Methods: In a multicenter treatment trial, 196 AA and 205 CA treatment-naive patients with hepatitis C virus (HCV) genotype 1 infection were treated with peginterferon alfa-2a (180 μg/wk) and ribavirin (1000-1200 mg/day) for up to 48 weeks. The primary end point was sustained virologic response (SVR). Results: Baseline features were similar among AA and CA, including HCV-RNA levels and histologic severity, but AA had higher body weights, a higher prevalence of diabetes and hypertension, and lower alanine transaminase levels (P < .001 for all). The SVR rate was 28% in AA and 52% in CA (P < .0001). Racial differences in viral responses were evident as early as treatment week 4. Breakthrough viremia was more frequent among AA than CA (13% vs 6%, P = .05); relapse rates were comparable (32% vs 25%, P = .30). Proportions of patients with serious adverse events and dose modifications and discontinuations were similar among AA and CA. In multiple regression analyses, CA had a higher SVR rate than AA (relative risk, 1.96; 95% confidence interval, 1.48-2.60; P < .0001). Other factors independently associated with higher SVR included female sex, lower baseline HCV-RNA level, less hepatic fibrosis, and more peginterferon taken. Conclusions: AA with chronic hepatitis C genotype 1 have lower rates of virologic response to peginterferon and ribavirin than CA. These differences are not explained by disease characteristics, baseline viral levels, or amount of medication taken.

Original languageEnglish (US)
Pages (from-to)470-477
Number of pages8
JournalGastroenterology
Volume131
Issue number2
DOIs
StatePublished - Aug 2006

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Conjeevaram, H. S., Fried, M. W., Jeffers, L. J., Terrault, N. A., Wiley-Lucas, T. E., Afdhal, N., Brown, R. S., Belle, S. H., Hoofnagle, J. H., Kleiner, D. E., & Howell, C. D. (2006). Peginterferon and Ribavirin Treatment in African American and Caucasian American Patients With Hepatitis C Genotype 1. Gastroenterology, 131(2), 470-477. https://doi.org/10.1053/j.gastro.2006.06.008