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 27 May 2018

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Hep C genotype determines sustained viral response in Black patients

Black patients with Hep C genotype 1, but not 2 or 3, have a lower sustained viral response rate than non-Blacks, and this is not explained by more frequent dose reductions of interferon and ribavirin, reports the latest Journal of Viral Hepatitis

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In previous Hepatitis C virus treatment studies, Black patients had a lower sustained viral response rate to interferon and ribavirin than non-Black patients.

In addition, Black patients had a higher frequency of Hepatitis C virus genotype 1 infection.

Dr Bräu and colleagues conducted a community-based study.

The research team determine whether Black patients have a lower sustained viral response rate independent of genotype.

The team prospectively enrolled 785 patients, of which 25% were Black, 72% were White, and 3% were of other ethnic groups.

Patients with genotype 2 or 3 received interferon alpha-2b 3 MU 3 times weekly plus ribavirin of 1000 to 1200 mg/day for 24 weeks.

In patients with genotype 1, this treatment regime was given for 48 weeks.

The researchers found that Black patients were more commonly infected with genotype 1.

The team also noted that these patients had a sustained viral response less frequently compared with non-Black patients.

50% with genotype 2/3 had sustained viral response vs 6% with genotype 1
Journal of Viral Hepatitis

Within genotype 1, Black patients had a lower sustained viral response rate of 6% compared to 14% for non-Black patients.

However, this was not the finding within genotype 2 or 3, where 50% of Black patients had a sustained viral response rate vs 37% in non-Black patients.

The team observed that Black patients had lower baseline hemoglobin levels, and neutrophil counts.

The Black patients required more frequent dose reductions of ribavirin, and interferon.

However, the team found that dose reductions were not associated with lower sustained viral response rates while early treatment discontinuations were.

Independent predictors of sustained viral response were genotype 1, Black race, and advanced fibrosis, stages 3 and 4.

Dr Bräu and team concluded, “Black patients infected with Hepatitis C virus genotype 1, but not 2 or 3, have a lower sustained viral response rate than non-Black patients.”

“This is not explained by their lower baseline haemoglobin levels and neutrophil counts that lead to higher rates of ribavirin and interferon dose reductions.”

J Vir Hep 2006: 13(4):
30 March 2006

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