Results of interferon-based treatments in Alaska Native and American Indian population with chronic hepatitis C

• Other Authors: Livingston, Stephen E., Townshend-Bulson, Lisa J., Bruden, Dana J. T., Homan, Chriss E., Gove, James E., Plotnik, Julia N., Simons, Brenna C., Spradling, Philip R., McMahon, Brian J.
• Language: unknown
• Subjects: Original Research Article; pegylated interferon; discontinuation; indigenous population; longitudinal study; sustained virologic response; Indian; Circumpolar Health; Alaska
• Online Access: http://stacks.cdc.gov/view/cdc/39194/

Background There have been few reports of hepatitis C virus (HCV) treatment results with interferon-based regimens in indigenous populations. Objective To determine interferon-based treatment outcome among Alaska Native and American Indian (AN/AI) population. Design In an outcomes study of 1,379 AN/AI persons with chronic HCV infection from 1995 through 2013, we examined treatment results of 189 persons treated with standard interferon, interferon plus ribavirin, pegylated interferon plus ribavirin and triple therapy with a protease inhibitor. For individuals treated with pegylated interferon and ribavirin, the effect of patient characteristics on response was also examined. Results Sustained virologic response (SVR) with standard interferon was 16.7% (3/18) and with standard interferon and ribavirin was 29.7% (11/37). Of 119 persons treated with pegylated interferon and ribavirin, 61 achieved SVR (51.3%), including 10 of 46 with genotype 1 (21.7%), 38 of 51 with genotype 2 (74.5%) and 13 of 22 with genotype 3 (59.1%). By multivariate analysis, SVR in the pegylated interferon group was associated with female sex (p=0.002), estimated duration of infection (p=0.034) and HCV genotype (p<0.0001). There was a high discontinuation rate due to side effects in those treated with pegylated interferon and ribavirin for genotype 1 (52.2%). Seven of 15 genotype 1 patients treated with pegylated interferon, ribavirin and telaprevir or boceprevir achieved SVR (46.7%). Conclusions We had success with pegylated interferon-based treatment of AN/AI people with genotypes 2 and 3. However, there were low SVR and high discontinuation rates for those with genotype 1. U01 PS001097/PS/NCHHSTP CDC HHS/United States U01 PS004113/PS/NCHHSTP CDC HHS/United States 27029671 PMC4814572