Hepatitis C: A Race Issue

HEPATITIS C: Hepatitis C (HCV) is the most common chronic blood borne infection in the United States and is caused by a virus. People at an increased risk for hepatitis C are those who:

Received a blood transfusion prior to July 1992,

Received blood, blood products, or solid organs from a donor who has hepatitis C,

Injected street drugs or shared a needle with someone who has hepatitis C,

Have been on long-term kidney dialysis,

As a healthcare worker, had frequent contact with blood on the job,

Have had sex with a person who has hepatitis C,

Shared personal items, such as toothbrushes and razors which may have blood on them, with someone who has hepatitis C.

Were born to hepatitis C infected mothers.

The incidence of hepatitis C infection is 3.9 million to 5 million people in the United States or approximately 1 in 70 to 100 people. It is more common in African Americans than in Caucasians.

TREATMENT: HCV positive people should be evaluated by their doctor for liver disease. Interferon and ribavirin are two drugs licensed for the treatment of chronic hepatitis C. Interferon can be taken alone or in combination with ribavirin. Combination therapy is currently the treatment of choice. However, not all patients respond well to therapy. In fact, African Americans and Whites respond very differently to treatment. Lennox Jeffers, M.D., from the University of Miami School of Medicine and VA Medical Center in Miami, says, "The response rate among African Americans to interferon alone was very dismal, approximately 0 to 1 percent. With interferon and ribavirin, it approaches anywhere from 10 to 20 percent." The response rate among whites is about 50 percent. Researchers are now studying how well African Americans will respond to therapy using the long-acting form of interferon, known as pegylated interferon, in combination with ribavirin. Dr. Jeffers says, "Hopefully with the pegylated product, it will increase the number of people who respond completely." Early studies show a 32-percent response rate among African Americans.

NEW STUDY: The Study of Viral Resistance to Antiviral Therapy of Chronic Hepatitis C (VIRAHEP-C) is a study funded by the National Institutes of Health. Across the United States, eight medical centers will enroll 200 African Americans and 200 Caucasians to participate in the study of combination therapy to determine the differences in treatment response between the two groups. The participating medical centers include: the Beth Israel Deaconess Medical Center in Boston, the New York-Presbyterian Medical Center, the University of Michigan, the University of North Carolina, the University of Maryland, the University of Miami, the University of California, and the University of Illinois.

FOR MORE INFORMATION, PLEASE CONTACT:
Lennox Jeffers, M.D.
University of Miami and VA Medical Center
1201 NW 16th St.
Miami, FL 33125
(305) 324-4455 Ext. 3172
E-mail: lennox.jeffers@med.va.gov