Journal article
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, Vol.13(4), pp.242-249
Received January 2005, accepted for publication April 2005
04/2006
DOI: 10.1111/j.1365-2893.2005.00682.x
PMID: 16611190
Abstract
Summary. 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.
Details
- Title: Subtitle
- 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
- Creators
- N Bräu - Veteran Affairs Medical Centers Bronx, NYE. J Bini - New York, NYS Currie - San Francisco, CAH Shen - San Francisco, CAW. N Schmidt - Iowa City, IAS. B Ho - Minneapolis, MNR. C Cheung - Palo Alto, CAK.-Q Hu - Loma Linda, CAB. S Anand - Houston, TXF. R Simon - Denver, COA Aytaman - Brooklyn, NYD. P Johnson - Bay Pines, FLJ. A Awad - Nashville, TNJ Ahmad - Pittsburgh, PAC. L Mendenhall - Cincinnati, OHM. C Pedrosa - Boston, MAR. H Moseley - Ann Arbor, MIC. H Hagedorn - Atlanta, GAB Waters - Memphis, TNK.-M Chang - Philadelphia, PAT. R Morgan - Long Beach, CAS. J Rossi - San Francisco, CAL. J Jeffers - Miami, FLT. L Wright - San Francisco, CAVA-HCV-001 Study Group
- Resource Type
- Journal article
- Publication Details
- Journal of viral hepatitis, Vol.13(4), pp.242-249
- Edition
- Received January 2005, accepted for publication April 2005
- Publisher
- Blackwell Publishing Ltd
- DOI
- 10.1111/j.1365-2893.2005.00682.x
- PMID
- 16611190
- ISSN
- 1352-0504
- eISSN
- 1365-2893
- Number of pages
- 8
- Language
- English
- Date published
- 04/2006
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984094661002771
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