Racial differences in responses to therapy with interferon... : Hepatology (original) (raw)

Original Articles: PDF Only

Reddy, Rajender K.1; Hoofnagle, Jay H. M.D., MD*,2; Tong, Myron J.3; Lee, William M.4; Pockros, Paul5; Heathcote, Jenny E.6; Albert, Donald7; Joh, Tenshang8

1University of Miami, Miami, FL

2Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD

3Huntington Memorial Hospital, Pasadena, CA

4University of Texas, Southwestern Medical Center, Dallas, TX

5Scripps Clinic, La Jolla, CA

6University of Toronto, Toronto, Ontario, Canada

7Amgen, Inc., Boulder, CO

8Thousand Oaks, CA

E-mail: [email protected]

*Address reprint requests to: Bldg. 31, Room 9A23, NIH, Bethesda, MD 20892. fax: 301-496-2830

Received February 25, 1999; accepted June 24, 1999; previously published online December 30, 2003

Abstract

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 μg) 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.