title: Results of interferon-based treatments in Alaska Native and American Indian population with chronic hepatitis C.
abstract: BACKGROUND
  There have been few reports of hepatitis C virus (HCV) treatment results with interferon-based regimens in indigenous populations.
  
  
  OBJECTIVE
  To determine interferon-based treatment outcome among Alaska Native and American Indian (AN/AI) population.
  
  
  METHODS
  In an outcomes study of 1,379 AN/AI persons with chronic HCV infection from 1995 through 2013, we examined treatment results of 189 persons treated with standard interferon, interferon plus ribavirin, pegylated interferon plus ribavirin and triple therapy with a protease inhibitor. For individuals treated with pegylated interferon and ribavirin, the effect of patient characteristics on response was also examined.
  
  
  RESULTS
  Sustained virologic response (SVR) with standard interferon was 16.7% (3/18) and with standard interferon and ribavirin was 29.7% (11/37). Of 119 persons treated with pegylated interferon and ribavirin, 61 achieved SVR (51.3%), including 10 of 46 with genotype 1 (21.7%), 38 of 51 with genotype 2 (74.5%) and 13 of 22 with genotype 3 (59.1%). By multivariate analysis, SVR in the pegylated interferon group was associated with female sex (p=0.002), estimated duration of infection (p=0.034) and HCV genotype (p<0.0001). There was a high discontinuation rate due to side effects in those treated with pegylated interferon and ribavirin for genotype 1 (52.2%). Seven of 15 genotype 1 patients treated with pegylated interferon, ribavirin and telaprevir or boceprevir achieved SVR (46.7%).
  
  
  CONCLUSIONS
  We had success with pegylated interferon-based treatment of AN/AI people with genotypes 2 and 3. However, there were low SVR and high discontinuation rates for those with genotype 1.
authors.affiliation: Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Livingston
authors.affiliation: Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Townshend-Bulson
authors.affiliation: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA.
authors.forename: Dana J T
authors.initials: DJ
authors.lastname: Bruden
authors.affiliation: Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: Chriss E
authors.initials: CE
authors.lastname: Homan
authors.affiliation: Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Gove
authors.affiliation: Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: Julia N
authors.initials: JN
authors.lastname: Plotnik
authors.affiliation: Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: Brenna C
authors.initials: BC
authors.lastname: Simons
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Spradling
authors.affiliation: Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.|Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA; bmcmahon@anthc.org.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: McMahon
mesh_terms: D000328:Adult; D000368:Aged; D000413:Alaska; D000072957:Alaska Natives / Q000706:statistics & numerical data; D000998:Antiviral Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000187:drug effects*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D016898:Interferon-alpha / Q000008:administration & dosage*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011994:Recombinant Proteins / Q000008:administration & dosage; D012254:Ribavirin / Q000008:administration & dosage*; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a
keywords: discontinuation; indigenous population; longitudinal study; pegylated interferon; sustained virologic response