Gaglio, PJ et al. (2004) Racial differences in response rates to consensus interferon in HCV infected patients naive to previous therapy. J Clin Gastroenterol 38: 599–604

Considerable progress has been made in the treatment of hepatitis C virus (HCV) infection in recent years, but little is known about how different racial and ethnic groups respond to therapy. Gaglio and colleagues have carried out a prospective study to examine responses according to race/ethnicity and HCV genotype.

Since the study began before the widespread introduction of PEG-interferon/ribavirin combination therapy, the 330 HCV-infected patients instead received induction therapy followed by consensus interferon (Infergen) every other day for 48 weeks. The primary endpoint was sustained virologic response (SVR), meaning undetectable HCV RNA in serum 6 months after treatment ended.

Of the group as a whole, 65% of patients described themselves as white, and 71% were infected with HCV genotype 1. The African-American subjects (14% of the group) showed a different genotype distribution, with 94% infected with HCV genotype 1. An SVR was achieved in a significantly greater proportion of white patients (24%) than in Hispanic patients (12%) or African-Americans (4%). Among genotype 1 patients, an SVR was recorded in 15% of whites and 13% of Hispanic patients, but only 2% of African-Americans (P = 0.001). In the genotype 2 group, a significantly lower proportion of Hispanic patients showed an SVR (10%) compared to African-Americans (50%) and whites (40%).

This study reveals significant differences in response rates to HCV therapy for different racial/ethnic groups, especially when analyzed by genotype. This highlights the importance of including adequate numbers of non-whites in future studies of HCV therapy.