Treatment of chronic hepatitis C virus in African Americans with genotypes 2 and 3

Previous studies have documented that sustained virologic response (SVR) is significantly reduced in African Americans with chronic HCV genotype 1 following treatment with interferon and ribavirin when compared with Caucasians. The specific aim of the present retrospective study was to assess virologic response to interferon and ribavirin in African Americans with HCV genotypes 2 and 3. A review of our database identified 42 African Americans and 334 Caucasians with HCV genotypes 2 and 3. Patients coinfected with hepatitis B or human immunodeficiency virus, chronic renal failure, and recipients of an organ transplant were excluded. Thirty of the African Americans were treated with either standard interferon or peginterferon and ribavirin as initial treatment for chronic HCV. Ninety of the 334 Caucasians were matched to the African Americans with regards to genotype, cirrhosis, treatment regimen, sex, age, and body weight for comparison of virologic response. The proportion of patients with HCV genotype 2 was significantly greater (P < 0.001) in African Americans compared with Caucasians (81%vs 52%). End-of-treatment virologic response was observed in 94% of Caucasians compared with 80% in African Americans (P= 0.036). SVR was observed in 82% and 57% of Caucasians and African Americans, respectively (P= 0.012). Similar results were observed when patients who had been treated with only peginterferon and ribavirin were assessed. These results suggest that African Americans have a global defect in their ability to eradicate HCV infection following treatment with interferon and ribavirin which transcends across all genotypes.