Treatment of Chronic Hepatitis C in African Americans with Genotype 2 or 3

Studies have shown that African Americans on the whole respond less well to interferon-based therapy for chronic hepatitis C, but the disparity may be less pronounced among individuals with easier-to-treat genotype 2 or 3 HCV.

As reported in the February 22, 2007 advance online edition of the American Journal of Gastroenterology, researchers performed a retrospective analysis to assess virological response to conventional or pegylated interferon plus ribavirin among African Americans with genotype 2 or 3 HCV.

A database review identified 42 African Americans and 334 Caucasians with genotype 2 or 3 chronic hepatitis C. Patients with hepatitis B virus or HIV coinfection, chronic renal failure, and organ transplant recipients were excluded. 30 African Americans with these genotypes were treated with either conventional or pegylated interferon plus ribavirin as initial therapy for chronic HCV infection. These patients were matched with 90 Caucasians with regards to sex, age, body weight, HCV genotype, presence of cirrhosis, and treatment regimen.

Results

• The proportion of patients with genotype 2 was significantly greater among African Americans compared with Caucasians (81% vs 52%).

• End-of-treatment virological response was observed in 94% of Caucasians compared with 80% of African Americans.

• Sustained virological response was observed in 82% of Caucasians and 57% of African Americans.

• Similar results were observed when the analysis was restricted to patients treated with pegylated interferon plus ribavirin.

Conclusion

In conclusion, the authors wrote, "These results suggest that African Americans have a global defect in their ability to eradicate HCV infection following treatment with interferon and ribavirin which transcends across all genotypes."

Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, Virginia; McGuire Veterans Administration Medical Center, Richmond, Virginia.

03/13/07

Reference

M L Shiffman, A A Mihas, F Millwala, and others. Treatment of Chronic Hepatitis C Virus in African Americans With Genotypes 2 and 3. American Journal of Gastroenterology. February 22, 2007 [Epub ahead of print].