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TITLE: Racial differences in responses to therapy
with interferon in chronic hepatitis C.
The likelihood of a sustained response to a course of interferon
in patients with chronic hepatitis C correlates with several
clinical and viral factors, including age, viral genotype and
initial levels of hepatitis C virus (HCV) RNA in serum. The role of
race and ethnicity has not been assessed. We evaluated the
association of race with response to interferon in a large
randomized, controlled trial using either consensus interferon (9
&mgr;g) or interferon alfa-2b (3 million units) given three
times weekly for 24 weeks. African-American patients participating
in the study were similar to white patients in mean age (43 vs. 42
years) and baseline levels of HCV RNA (3.6 vs. 3.0 million
copies/mL) but had lower rates of cirrhosis (5% vs. 12%) and more
frequently had viral genotype 1 (88% vs. 66%: P =.004). Most
strikingly, the rates of end-of-treatment and sustained virological
responses were lower among the 40 African-American patients (5% and
2%) than among the 380 white patients (33% and 12%) (P =.04
and.07). Rates of response among Hispanic and Asian-American
patients were not statistically different than non-Hispanic white
patients. Median viral levels decreased by week 24 of therapy by
2.5 logs in white patients (from 3.0 to 0.012 million copies/mL)
but by only 0.5 logs among African- American patients (from 3.6 to
1.8 million copies/mL). Thus, there are marked racial differences
in virological responses to interferon in hepatitis C that must be
considered in assessing trials of interferon therapy and in
counseling patients regarding treatment. The differences in
response rates are as yet unexplained.
AUTHOR: Reddy KR, Hoofnagle JH, Tong MJ, Lee WM, Pockros P,
Heathcote EJ, Albert D, Joh T, University of Miami, Miami, FL.
SOURCE: Hepatology 1999 Sep;30(3):787-93
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