Thursday, April 7, 2011

SUBTYPE 1B DOES NOT CONFER A TREATMENT ADVANTAGE TO HCV INFECTED AFRICAN AMERICAN PATIENTS TREATED WITH PEG+RBV

Session Title: Category 08b: Viral Hepatitis C: Clinical (except therapy)


Presentation Date: 02 APR, 2011

SUBTYPE 1B DOES NOT CONFER A TREATMENT ADVANTAGE TO HCV INFECTED AFRICAN AMERICAN PATIENTS TREATED WITH PEG+RBV

E. Jenkins*, N. Reau, A. Aronsohn, S. Mohanty, K.G. Reddy, D.M. Jensen

Hepatology, University of Chicago, Chicago, IL, USA. *erin.jenkins@uchospitals.edu

Background: Baseline factors can predict treatment efficacy in patients infected with HCV. Some studies, especially in European subjects, have suggested that HCV genotype 1b (G-1b) is more responsive than genotype 1a (G-1a) to standard therapy with PEG/RBV.

Aims: To measure the prevalence of HCV G-1b and G-1a and to determine if subtype affects efficacy of treatment.

Methods: Retrospective analysis of all outpatient HCV patient charts who received HCV therapy between 2005-20010. 208 genotype 1 patients were identified. Subtype, demographics, disease specific data and therapeutic outcome were extrapolated. 32 patients were excluded from evaluation due to the inability to subtype their HCV, having a subtype other than a or b, or having a mixed genotype. Fisher's exact test and polytomous logistic regression were used to test for associations between the variables subtype, SVR and race.

Results: 176 Patients were included in the evaluation. Patient and viral characteristics were well matched as below. Overall, 28% of G-1a patients achieved SVR compared to 26% G-1b (OR G-1a vs G-1b 1.097, p=0.799). There were 84 African American (AA) patients included in the study, (44% G-1a and 53%G-1b). SVR rates were no different between subtypes with 17% of G-1a AA patients achieving SVR compared to 11% G-1b . 37% G-1a vs. 42% G-1b non-AA achieved SVR. The odds of obtaining SVR was significantly lower for AA vs non-AA patients (OR AA vs. non-AA 0.253, p = .0006.)


Baseline Factors......G-1a (n=70).......G - 1b (n=106)

Ave Age............................. 51..................54

Male (%)............................ 37..................53

Cirrhosis (%)...................... 25..................37

ALT................................... 73..................92

Platelet count.................... 207................196

HCV PCR log 10.............6.52...............6.44

Weight kg...........................87...................86

AA (%)............................. 44...................53

SVR (%)............................28...................26

[Table 1]

Conclusions: G-1b subtype is common among AA patients and offers no advantage to treatment with PEG+RBV.

http://www1.easl.eu/easl2011/program/Posters/Abstract1036.htm

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