Interferon (IFN) Based Treatment of African Americans with Chronic Hepatitis C (CHC) in an Urban Clinic: Improving Response with Advances in Therapy

Abstract

AIM:In this paper, we review the results of the addition of a direct acting antiviral (DAA) to dual therapy [Pegylated-Interferon (Peg-IFN)+Ribavirin (Riba)] therapy in African Americans (AA) treated for chronic hepatitis C (CHC) in an urban GI clinic as compared to the licensing studies.

Decreasing racial disparity with the combination of ledipasvir–sofosbuvir for the treatment of chronic hepatitis C

“…For example, it was only after pooling of clinical trial patients that first generation direct-acting antiviral (DAA) triple therapy (telaprevir/boceprevir + interferon, and ribavirin) was shown to be better than dual therapy (interferon and ribavirin) for both races, but AA patients still had a lower response than Caucasians 10. These observations were recently confirmed in a study by Naylor et al12 in a “real world” clinic setting, where the predominant population being treated was AA.…”

Real World Response to Direct Acting Antivirals DAA in African Americans Treated in a Non-Gastroenterology Setting

“…African Americans (AA) who are more likely to be infected with hepatitis C than Caucasians, comprise 23% of infected population, are more likely to develop hepatocellular carcinoma than non-AA populations in the United States, and are more likely to be infected with hepatitis C genotype [5][6][7][8][9][10] . Ribavirin/Interferon based regimens were less effective in the African American population which helped to contribute to the increased numbers of AA patients with CHC [11][12][13][14][15][16] . The utilization of dual direct acting antiviral agent (DAA) combinations such as sofosbuvir/ledipasvir (Harvoni®) has provided a shift into an oral, tolerable and effective regimen with fixed dosing and treatment period [17] .…”