Response to Hep C Treatment Worse for Blacks
Only 19% of Black Patients Are Cured vs. 52% for Whites
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Response Rate Lower Than in Whites, But Better Than the Past continued...
Muir tells WebMD that despite the difference in treatment outcomes, it would never be justifiable to withhold hepatitis C treatment on the basis of race alone. He points out that the 19% response rate to treatment seen among blacks is higher than that achieved in all patients treated with early hepatitis C drugs just over a decade ago.
"The decision to treat any hepatitis C patient is a complex one, and this is just one of the factors that needs to be weighed in discussions between physicians and African-American patients," he says.
Patients Still Benefit
Alexandria, Virginia physician Jonathan McCone, MD, who was a participating investigator in the Duke study, adds that many patients who do not achieve sustained responses to treatment still seem to benefit from it.
"I have seen this personally in my practice and studies have shown this," McCone tells WebMD. "Therapy actually reverses some of the liver damage and buys patients time by keeping them healthy so they don't degenerate to the point of needing a liver transplant or developing liver cancer."
McCone added that findings from this and other studies can be seen as encouraging because responses to early hepatitis C treatments among black patients was close to zero.
"Just a few years ago response to treatment was poor for everybody and absolutely horrible for African Americans," he says. "We now see sustained viral clearance in 20%-25% of a historically difficult to treat population. That is pretty significant."
SOURCES: Muir et al., The New England Journal of Medicine, May 27, 2004; Vol. 350: pp. 2265-2271. Andrew J. Muir, MD, assistant professor of medicine, division of gastrointerology, Duke University Medical Center, Durham, NC. Jonathan McCone, MD, director, Mount Vernon Endoscopy Center, Alexandria, VA. Bruce Bacon, MD, professor of internal medicine; division of gastrointerology and hepatology, St. Louis University School of Medicine.