Direct-Acting Antiviral Therapy for Hepatitis C Infection in a Large Immigrant Community
- 71 Downloads
Hepatitis C treatment has rapidly evolved with the arrival of direct-acting antiviral therapy. Sustained virologic response (SVR) rates in clinical trials are high but it is unknown how this translates to the immigrant community. Data from December 2013 to September 2015 was collected from a Midwest academic and community practice with a large immigrant population. There were 802 patients with an overall SVR rate of 88%. Ledipasvir/sofosbuvir was associated with favorable response among genotype 1 and 4 patients compared to other regimens (p < 0.001 and p = 0.05). Factors associated with treatment failure included advanced liver disease, male gender, East African/Middle Eastern ethnicity, and non-compliance. Patients with genotype 4 had lower SVR rates than other genotypes (58% vs. 89%, p < 0.001), particularly among East Africans (40% vs. 82% for other ethnicities). Our SVR rate for genotype 4 infection is lower than clinical trials and may be related to cultural, biologic and socioeconomic factors.
KeywordsHepatitis C Antiviral Cirrhosis Ethnicity
No funding was needed to complete this study.
Compliance with Ethical Standards
Conflict of interest
John Lake has received research grants from AbbVie and Mark Boldt has an advisory arrangement for Gilead and AbbVie and is a consultant with AbbVie. All remaining authors declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was waived from individual participants based on exempt status as a retrospective chart review. This study was reviewed and approved by the Institutional Review Board at the University of Minnesota.
Research Involving Human and Animal Rights
This article does not contain any studies with animals performed by any of the authors.
- 5.Lawitz E, Sulkowski MS, Ghalib R, et al. Simeprevir plus sofosbuvir, with or without ribavirin, to treat chronic infection with hepatitis C virus genotype 1 in non-responders to pegylated interferon and ribavirin and treatment-naive patients: the COSMOS randomised study. Lancet. 2014;384(9956):1756–65.CrossRefGoogle Scholar
- 11.U.S. Census Bureau (2010). The foreign-born population from Africa: 2008–2012. https://www.census.gov/content/dam/Census/library/publications/ 2014/acs/acsbr12-16.pdf. Accessed 11 Dec 2015
- 14.U.S Census Bureau (2010). The Asian population: 2010. https://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf. Accessed 11 Dec 2015
- 20.Hezode C, Asselah T, Reddy KR, et al. Ombitasvir plus paritaprevir plus ritonavir with or without ribavirin in treatment-naive and treatment-experienced patients with genotype 4 chronic hepatitis C virus infection (PEARL-I): a randomised, open-label trial. Lancet 2015;385(9986):2502–9.CrossRefGoogle Scholar
- 25.Osinusi A, Marti M, Kohli A, et al. Sofosbuvir/ledipasvir in retreatment of HCV genotype-1 patients who previously failed sofosbuvir/ribavirin therapy. [Abstract 011.] 49th Annual Meeting of the European Association for the Study of the Liver (EASL). April 9–13, 2014a; London, United Kingdom.Google Scholar
- 26.Lawitz E, Poordad FF, Pang PS, et al. Sofosbuvir and ledipasvir fixed-dose combination with and without ribavirin in treatment-naive and previously treated patients with genotype 1 hepatitis C virus infection (LONESTAR): an open-label, randomised, phase 2 trial. Lancet. 2014;383(9916):515–23.CrossRefGoogle Scholar
- 28.Foster GR, Pianko S, Cooper C, et al. Sofosbuvir + peginterferon/ribavirin for 12 weeks vs sofosbuvir + ribavirin for 16 or 24 weeks in genotype 3 HCV infected patients and treatment-experienced cirrhotic patients with genotype 2 HCV: the BOSON study. [Abstract L05.] 50th Annual Meeting of the European Association for the Study of the Liver (EASL). April 22–26, 2015; Vienna, Austria.Google Scholar
- 30.Guidance HCV. Recommendations for Testing, Managing, and Treating Hepatitis C. https://www.hcvguidelines.org. Accessed 5 Jan 2018
- 33.U.S. Census Bureau (2009). American community survey. https://usa.ipums.org/usa/index.shtml. Accessed 11 Dec 2015