Chronic Hepatitis С in African Americans: RESULTS

Patient Demographics prior to Treatment

Table 1 outlines the baseline characteristics of our patient population, consisting of 73 individuals of multiethnic backgrounds who opted for therapy. This included 38 non-Hispanic Caucasians, 24 African Americans, three Hispanics, and eight Asian or Middle Easterners. There were a total of 50 patients who were genotype 1 and 23 patients who were nongenotype 1. The enrollment of the cohorts occurred concurrently, and the baseline characteristics of the groups were similar.

Table 1. Comparison of baseline features—African-Americans versus non-African Americans

Characteristics                African Americans (N=24)

Non-AA (N=49)
Genotype 1 88%

59%

Sex
Males 51%

56%

Females 49%

44%

Mean age (years) 49

43

Mean ALT IU/L pre-TX 92

107

Viral RNA >1 million pre-TX 25%

33%

Liver biopsy with stage-3 or -4 fibrosis 33%

36%

Patients Who Declined or Who Were Not Offered Treatment

Of the 193 patients who were potentially eligible for therapy, 120 patients were not treated for one or more reasons. The majority (>90%) of these individuals had mild HCV on liver biopsy with normal ALT values; were asymptomatic; and declined treatment, opting for expectant management, often due to perceived low efficacy of therapy in the face of significant side effects. Patients with suboptimally managed depression or other psychiatric disorders were often not willing to be followed by a psychiatrist during treatment, and therapy was not offered to these individuals. We also elected not to treat patients who had undergone a prior kidney transplant due to the controversy that still surrounds graft loss following interferon therapy. Patients with decompensated liver disease who were not deemed eligible for treatment were referred for liver transplant evaluation at our center.
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Table 2. ETR and SVR data based on genotype, N=73

Race

Geno 1 ETR Geno 1 SVR Nongeno 1 ETR Nongeno 1 SVR Overall ETR Overall SVR
African-American (N=24) 8/21=38%

4/21=19%

3/3=100%

2/3=66%

11/24=46%

6/24=25%

Caucasian (N=38)

14/27=52%

6/27=22%

11/11=100%

7/11=64%

25/38=66%

13/38=34%

Other (Hispanics and Asians) (N=11)

1/2=50%

1/2=50%

8/9=89%

4/9=44%

9/11=82%

5/11=45%

Non-African-American (N=49)

15/29=52%

7/29=24%

19/20=95%

11/20=55%

34/49=69%

18/49=37%

Total (N=73)

23/50=46%

11/50=22%

22/23=96%

13/23=57%

45/73=62%

24/73=32%

Overall Response by Race and Genotype

Table 2 summarizes the ETR and SVR rates for the 73 patients who have completed treatment to date. The patients are analyzed according to race and genotype 1 versus nongenotype 1. African Americans accounted for 33% of the entire population and non-African Americans accounted for 67%. The overall population consisted of 68% genotype 1 and 32% nongenotype-1 patients, with 88% of African Americans being genotype 1 and 59% of non-African Americans being genotype 1. The SVR rate for African Americans who were genotype 1 was 19%, compared to 24% for non-African-American patients with genotype 1. There was no statistically significant difference (using a Student’s t test) in these SVR rates between the African-American and non-African-American genotype-1 patients For our entire population of patients, the overall ETR rate was 62% and the overall SVR rate was 32%. cialis 10 mg

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