Impaired response to high-dose interferon treatment in African-Americans with chronic hepatitis C.
OBJECTIVE
The prevalence of hepatitis C virus infection in the USA is higher among African-Americans than among Caucasians. Despite this, little information is available on the course of hepatitis C virus infection in Blacks and in other minority groups. The aim of this retrospective case-control study was to determine the response rate to high dose interferon-alpha treatment in two racial groups with chronic hepatitis C virus infection.


METHODS
Thirty-one African-Americans and 62 Caucasians with chronic hepatitis C were considered in the study. The subjects were matched for gender, age, presence/absence of cirrhosis, histologic score, and viral genotype. All were treated with interferon-alpha (5 mU/day for 12 months). Three end-points (on-therapy, after 6 months of interferon-alpha, end-of-therapy, at the end of the 12 months of treatment, and off-therapy, 6 months after treatment) were chosen to describe the response to interferon-alpha treatment.


RESULTS
African-Americans had a significantly reduced response to interferon-alpha as compared to Caucasians at all end-points. At the on-therapy end-point, 26% of African-Americans were HCV-RNA negative and had normal transaminases level as compared to 60% of the Caucasians (P < 0.01); at the end-of-therapy end-point the rates were, respectively, 10% and 53% (P < 0.0001). No differences were detected in terms of pretreatment serum ALT, HCV-RNA, iron and ferritin levels or hepatic iron contents between the two groups.


CONCLUSIONS
African-Americans have a reduced response to high-dose interferon-alpha treatment as compared to Caucasians. Both environmental and genetic factors may be implicated in this impaired ability to clear hepatitis C virus infection.
De Maria
Nicola
N
Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, Loyola University Medical Center, Building 114, Room 48, 2160 South 1st Ave, Maywood, IL 60153, USA. ndemari@luc.edu
Colantoni
Alessandra
A
Idilman
Ramazan
R
Friedlander
Lois
L
Harig
James
J
Van Thiel
David H
DH
D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D044383:Black People; D016022:Case-Control Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000208:ethnology* / Q000473:pathology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D044465:White People; D001741:Black or African American
D000998:Antiviral Agents; D016898:Interferon-alpha