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首页> 外文期刊>Journal of clinical gastroenterology >Equally poor outcomes to pegylated interferon-based therapy in African Americans and Hispanics with chronic hepatitis C infection.
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Equally poor outcomes to pegylated interferon-based therapy in African Americans and Hispanics with chronic hepatitis C infection.

机译：与慢性丙型肝炎感染的非洲裔美国人和西班牙语在非洲裔美国人和西班牙裔中，同样差的结果。

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OBJECTIVES: Treatment response to pegylated interferon based regimen is different between African Americans and Whites, but little comparable data is available comparing Hispanics and African Americans. PATIENTS: We retrospectively evaluated the rate of success in the treatment completion and response to peginterferon alpha-2a or alpha-2b plus ribavirin in 103 (male:female-69:34) hepatitis C virus (HCV)-polymerase chain reaction positive patients that included 68 Hispanic and 35 African Americans. METHODS: Patients were treated with peginterferon alpha-2a 180 mcg/wk (n=25) or peginterferon alpha-2b 1.5 mcg/kg/wk (N=78) and ribavirin 1000 to 1200 mg/d for 24 weeks (genotype 2 and 3) or 48 weeks (genotype 1 and 4) based on the genotype of the patient. Treatment was discontinued if the patients failed to have a 2-log drop in viral load after 12 weeks of treatment. Primary aim of the study was to evaluate success in completing a scheduled duration of pegylated interferon and ribavirin treatment in patients with chronic HCV infection and the reasons for discontinuation of the treatment. The secondary aim was to look for the end of treatment virologic response and sustained virologic response. The analysis was conducted by intention-to-treat. RESULTS: Of the 103 patients included in the study, 50 (48.5%) patients dropped out of the treatment because of side effects of the drug or noncompliance to the treatment protocol or alternate reasons; 44 (42.7%) of them could not continue beyond 12 weeks of therapy. There were no significant differences in the drop out rate between the African American [15 (43%)] and Hispanic [35 (51.5%)] patients (P=0.41). Overall, 41% of the patients completed the scheduled 24 week or 48 week treatment. HCV genotype-1 was the most prevalent genotype in both African Americans and Hispanics (88.6% vs. 75%, P=0.10). Overall end of the treatment response (ETR) was 29.1% (30/103) and sustained virologic response (SVR) was 23.3% (24/103) in this population. No significant differences were noted in the ETR (20% vs. 34%, P=0.14) and the SVR (20% vs. 25%, P=0.57) between the African Americans and Hispanics. When data were analyzed by genotype, overall SVR rates were 14.6% (12/82) in genotype 1 versus 57% (12/21) in genotype 2/3/4 (P<0.0001). Both these ethnic groups had comparable response rates when only patients with genotype-1 were considered 5/31 (16.1%) versus 7/51 (13.7%, P=0.76). CONCLUSIONS: A significant proportion of the African Americans and Hispanics referred for HCV treatment with pegylated interferon dropped out early in the therapy, suggesting possible racial, socioeconomic, and cultural barriers in successful treatment for chronic HCV infection. Overall, both groups had similar poor response rates, well below those reported for White patients. As is true for the general population, patients with nongenotype 1 infection had a significantly better ETR and SVR.
机译：目的：对非洲裔美国人和白人的Pegymated干扰素方案的治疗响应是不同的，但是可以比较西班牙裔和非洲裔美国人的可比数据很少。患者：我们回顾性地评估了治疗完成的成功率，并在103（男性：雌性-69：34）丙型肝炎病毒（HCV） - 聚合酶链反应阳性患者中的治疗完成和对Peginterferonα-2a或α-2b加基韦林的成功率包括68个西班牙裔和35名非洲裔美国人。方法：患者用Peginterferonα-2a 180mcg / Wk（n = 25）或Peginterferonα-2b 1.5mcg / kg / wk（n = 78）和利巴韦林1000至1200mg / d 24周（基因型2和3）基于患者的基因型48周（基因型1和4）。如果患者在治疗12周后病毒载量未能在病毒载量下降2次降落，则停止治疗。该研究的主要目的是评估在慢性HCV感染患者中完成预定的聚乙二醇干扰素和利巴韦林治疗的预定持续时间，以及停止治疗的原因。二次目的是寻找治疗病毒性反应和持续的病毒性反应结束。分析是通过意向治疗进行的。结果：该研究中包括的103名患者，50例（48.5％）患者因药物的副作用或非达到治疗方案或另外原因而退出治疗患者; 44（42.7％）他们不能超过12周的治疗。非洲裔美国[15（43％）]和西班牙裔（51.5％）]患者（P = 0.41），辍学率没有显着差异。总体而言，41％的患者完成了预定的24周或48周的治疗。 HCV基因型-1是非洲裔美国人和西班牙裔人中最普遍的基因型（88.6％vs.75％，P = 0.10）。治疗响应（ETR）的总体结束是29.1％（30/103），持续的病毒学反应（SVR）在该群体中为23.3％（24/103）。在ETR（20％对34％，P = 0.14）中没有发现显着差异（20％对34％，P = 0.14），而非洲裔美国人和西班牙裔人之间的SVR（20％vs.25％，P = 0.57）。当通过基因型分析数据时，总SVR率为14.6％（12/82），基因型1与57％（12/21）在基因型2/3/4（P <0.0001）中。当只有基因型-1的患者被认为是5/31（16.1％）而不是7/51（13.7％，P = 0.76）时，这两个族裔群体都具有可比的响应率。结论：在治疗早期辍学的非洲裔美国人和西班牙裔美国人和西班牙裔人提到的大部分非洲裔美国人和西班牙裔人，建议在成功治疗慢性HCV感染方面可能的种族，社会经济和文化障碍。总体而言，这两组都有类似的反应率，远低于白人患者的差。对于一般人群而言，Nongenotype 1感染的患者具有明显更好的ETR和SVR。

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