Lower Viral Response to Pegylated Interferon Alpha 2a Treatment of Chronic Hepatitis B in Roma People in Eastern Slovakia

Abstract

Aim. To evaluate the compliance and virological response to pegylated interferon alpha 2a treatment of chronic hepatitis B in Roma population compared to majority Caucasian population in Slovakia. Methods. Retrospective evaluation of a cohort of all Roma patients treated with pegylated interferon alpha 2a from 2007 to 2013 in 3 centers for treatment of chronic viral hepatitis B. The Study included 43 Roma patients with chronic viral hepatitis B and randomly selected control group. Treatment duration was 48 weeks. Viral response was evaluated after 24 weeks, at the end of treatment, and 24 weeks after the end of treatment. Results. Complete treatment course was finished by 79.1% of Roma patients compared to all patients from the control group (p = 0.0009). There was a tendency toward lower viral response rate in Roma at all time points; however significant difference was only at end of treatment viral response (51.2% Roma versus 81.4% majority, p = 0.003). We also did not find significant difference at the rate of HBsAg loss. Conclusion. Roma patients with chronic hepatitis B have significantly worse compliance to treatment with pegylated interferon and they have significantly lower rate of end of treatment viral response.

The Roma Population Living in Segregated Settlements in Eastern Slovakia Has a Higher Prevalence of Metabolic Syndrome, Kidney Disease, Viral Hepatitis B and E, and Some Parasitic Diseases Compared to the Majority Population

“…Currently, a multitude of therapeutic options exist for the treatment of chronic hepatitis B, in which patients achieve the virologic response desired in the vast majority of cases. However, Roma have less compliance to the treatment of chronic hepatitis B with pegylated interferons than the majority population [54]. The optimal way to prevent the spread of hepatitis B virus in the Roma settlements would be to vaccinate patients who do not yet show serological markers of hepatitis B.…”

Prevalence and Risk Factors for Hepatitis B Virus Infection in Roma and Non-Roma People in Slovakia

“…In a previously published retrospective analysis from our group we reported that Pegylated interferon alpha treatment was completed by 100% patients from the non-Roma but only 79% patients from Roma population ( p = 0.0009). This led to the lower rate of virological response at the end of treatment in Roma population (51% versus 81%; p = 0.003) [ 28 ]. HBsAg positive participants in this study, who fulfilled treatment criteria, were contacted through their general practitioner and were offered the standard of care treatment with nucleot(s)ide analogues or pegylated interferon alpha.…”

What is the Role of the Horizontal Transmission of Hepatitis B Virus Infection in Young Adult and Middle-Aged Roma Population Living in the Settlements in East Slovakia?

“…Today, there are two treatment options for chronic hepatitis B-treatment with nucleot(s)ides analogues or PEG IFN alpha 2a [28]. Roma people compliance in the treatment with PEG IFN alpha 2a is suboptimal, which is associated with achieving a poorer virologic response [29]. At present, a long-term treatment with nucleot(s)ides analogues (entecavir, tenofovir, tenofovir alafenamide), which leads to suppression of HBV infection in near to all infected patients is preferred [28].…”