Race May Affect Ability to Achieve SVR in Hepatitis C
Hepatitis C virus genotype 1 was the most common type in participants in this study.
After being treated with direct-acting antivirals, African Americans with hepatitis C are less likely to achieve sustained virologic response at 12 weeks (SVR12) compared with white patients, according to results published in Pharmacology Research & Perspectives.
Patients with hepatitis C who have advanced fibrosis are also less likely to achieve SVR12 than patients who do not have fibrosis.
The study included patients undergoing direct-acting antiviral therapy for hepatitis C at the Veterans Affairs Greater Los Angeles Healthcare System in California from 2014 to 2016 (n=1068). The researchers performed a multivariable logistic regression analysis to determine predictors of SVR12, adjusting for age, hepatitis C genotype, treatment regimen and duration, HIV status, fibrosis, nonalcoholic fatty liver disease fibrosis score, homelessness, mental health, and adherence.
Of the 1068 participants, 37.5% were white (n=401) and 37.5% were black (n=400). The most common hepatitis C genotype in the participants was genotype 1 (83.9%, n=896).
After adjusting for variables, the researchers found that race/ethnicity and the presence of fibrosis were statistically significant predictors of non-SVR. African American participants had 57% lower odds for reaching SVR12 (adjusted OR 0.43; 95% CI, 1.5-4.1) compared with white participants. Advanced fibrosis (adjusted OR 0.40; 95% CI, 0.26-0.68) was also a significant predictor of non-SVR.
“Although our data demonstrate the importance of racial/ethnic differences, the true etiology of these differences remains unclear, which can be further explored in prospective studies where drug levels and patient genetics are taken into account,” the researchers wrote.
Benhammou JN, Dong TS, May FP, et al. Race affects SVR12 in a large and ethnically diverse hepatitis C-infected patient population following treatment with direct-acting antivirals: analysis of a single-center Department of Veterans Affairs cohort [published online February 22, 2018]. Pharmacol Res Perspect. doi:10.1002/prp2.379