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 24 February 2018

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News

Peginterferon alfa-2a and ribavirin in Hep C

This week’s issue of the New England Journal of Medicine investigates the effect of peginterferon alfa-2a and ribavirin in Latino and non-Latino Whites with Hepatitis C.

News image

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Race has been shown to be a factor in the response to therapy for Hepatitis C virus infection, and limited data suggest that ethnic group may be as well.

However, Latinos and other ethnic subpopulations have been underrepresented in clinical trials.

Dr Maribel Rodriguez-Torres and colleagues evaluated the effect of Latino ethnic background on the response to treatment with peginterferon alfa-2a and ribavirin in patients infected with Hepatitis C genotype 1 who had not been treated previously.

The research team conducted a multicenter, open-label, nonrandomized, prospective study of 269 Latino and 300 non-Latino whites with Hepatitis C infection.

The patients were randomized to peginterferon alfa-2a, at a dose of 180 µg per week, or ribavirin, at a dose of 1000 or 1200 mg per day, for 48 weeks, and were followed through 72 weeks.

The rate of sustained virologic response was 49% among non-Latino whites
New England Journal of Medicine

The primary end point was a sustained virologic response.

The research team enrolled Latinos whose parents and grandparents spoke Spanish as their primary language, and nonwhite Latinos were excluded.

Baseline characteristics were similar in the Latino and non-Latino groups.

However, the team noted that higher proportions of Latino patients were 40 years of age or younger, had a body-mass index of more than 27 or more than 30, and had cirrhosis.

The rate of sustained virologic response was higher among non-Latino whites than among Latinos, at 49% vs 34%.

The absence of Hepatitis C RNA in serum was more frequent in non-Latino whites at week 4, and throughout the treatment period.

Latino or non-Latino background was an independent predictor of the rate of sustained virologic response in an analysis adjusted for baseline differences in body mass index, cirrhosis, and other characteristics.

The research team found that adherence to treatment did not differ significantly between the 2 groups.

The team noted that the numbers of patients with adverse events and dose modifications were similar in the 2 groups, but fewer Latino patients discontinued therapy because of adverse events.

Dr Maribel Rodriguez-Torres’ team concluded, “Treatment with peginterferon alfa-2a and ribavirin for 48 weeks resulted in rates of sustained virologic response among patients infected with Hepatitis C genotype 1 that were lower among Latino whites than among non-Latino whites.”

“Strategies to improve the sustained virologic response in Latinos are needed.”

NEJM 2009: 360(3): 257-67


20 January 2009

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