Hepatitis C treatment among racial and ethnic groups

Hepatitis C treatment among racial and ethnic groups

This month's Journal of Viral Hepatitis reports that decisions regarding HCV treatment should consider the predictive value of the early on-treatment response, not just baseline characteristics.

Previous studies of chronic hepatitis C virus (HCV) treatment have demonstrated variations in response among racial and ethnic groups including poorer efficacy rates among African American and Hispanic patients. Dr Muir and colleagues from North Carolina investigated the individualized dosing efficacy vs flat dosing to assess optimal pegylated interferon therapy. The IDEAL trial enrolled 3070 patients from 118 United States centers to compare treatment with peginterferon (PEG-IFN) alfa-2a and ribavirin, and 2 doses of PEG-IFN alfa-2b and ribavirin. The research team examined treatment response among the major racial and ethnic groups in the trial. Overall, sustained virologic response rates were 44% for white, 22% for African American, 38% for Hispanic and 59% for Asian American patients. The sustained virologic response rate was 59% for Asian American patients Journal of Viral Hepatitis For patients with undetectable HCV RNA at treatment week 4, the positive predictive value of sustained virological response was 86% for white, 92% for African American, 83% for Hispanic and 89% for Asian American patients. The positive predictive values of sustained virologic response in those with undetectable HCV RNA at treatment week 12 ranged from 72% to 81%. The team demonstrated that treatment regimen was not a predictor of sustained virologic response. The researchers observed that despite wide-ranging sustained virologic response rates among the different racial and ethnic groups, white and Hispanic patients had similar sustained virologic response rates. In all groups, treatment response was largely determined by antiviral activity in the first 12 weeks of treatment. Dr Muir and team comments, "Therefore, decisions regarding HCV treatment should consider the predictive value of the early on-treatment response, not just baseline characteristics, such as race and ethnicity."

J Viral Hep 2011: 18(4): e134–e143 20 April 2011