11 Treatment Response and Tolerability to Pegylated Interferon (PEG Inf) and Ribavirin (RBV) in Treatment-Naïve Asian American Patients with Chronic Hepatitis C and Genotype 1, 2/3 and 6

Abstract

PURPOSE: The total number of individuals infected with the hepatitis C virus (HCV) from the Asia Pacific region is 4x greater than that from the Americas/Europe combined (94.5 vs. 22 million). Yet, Asians remain one of the least studied HCV patient groups. Our goal was to examine treatment outcomes and tolerability in this population. METHODS: A total of 199 consecutive treatment-naive AA patients treated with PEG IFN+RBV by 5 gastroenterologists at a U.S. community clinic in 12/00-1/08 were included in the study. Primary outcome was sustained-virological-response (SVR) rate by intention-to-treat analysis. Treatment adherence was defined as completion of ≥ 80% PEG IFN and RBV dose for ≥ 80% of intended duration. RESULTS: Mean age was 49 + 10, 63% were male, and 9% had cirrhosis. Treatment adherence rate was 39%. The most common side effect besides constitutional symptoms was anemia requiring erythropoietin (EPO): 27%. Significant depression was noted in only 1.5% of patients. SVR rate in genotypes 6 patients treated for 48 weeks was similar to that seen in genotypes 2/3 patients (81% vs. 88%, p=0.43) (Figure 1). Genotype 6 patients treated for 24 weeks had similar SVR to that of genotype 1 patients (56% vs. 59%, p=0.92). On multivariate analysis also inclusive of viral load and sex, independent predictors for SVR were treatment adherence (OR=5.86, p 25 (OR=0.88, p=0.048) and older age (OR=0.13, p 55. CONCLUSION: In Asian patients, older age >45, BMI>25 were associated with poorer SVR rates while treatment adherence strongly predicts a positive outcomes. Anemia requiring EPO is a common side effect (27%) while significant depression is rare (1.5%). Patients with genotype 6 can expect to have a favorable SVR rate as patients with genotype 2/3 if treated for 48 weeks.