Decreasing Racial Disparity with Interferon-Free Regimens in African American Patients with Chronic Hepatitis C

Introduction: Racial disparity in response to hepatitis C treatments when comparing African Americans (AA) to Caucasians (Cau) was a disconcerting fi nding in the Interferon-Ribavirin treatment era. Th e objective of this study was to compare combinations of direct acting anti-viral agents (DAAs) to single DAA administered with ribavirin and interferon (R+I+DAA) in AA patients. Methods: Data from the medical records of patients treated with a DAA from Aug 2011 to March 2016 were included in this IRB-approved study. Response rate to therapy with DAAs or R+I+DAA was calculated as intent to treat (ITT), and sustained viral response (SVR) was defi ned as a negative HCV PCR assay 12 weeks aft er completion of therapy. AST-Platelet Ratio Index (APRI) was used to assess improvement in fi brosis following treatment. Results: Th e majority of the 325 patients were African American (89%), Male (60%) and Genotype 1 (97%) with a median age of 61 years of age. Combination DAAs were used in 67% of the patients with the remaining receiving R+I+DAA. Th ere were more naïve patients in the combination DAAs group as compared to R+I+DAA group (47% vs 26% (AA); 54% vs 13% Cau). SVR for AA Genotype 1 patients receiving combination DAAs as compared to R+I+DAA was signifi cantly better (96% vs 37%; Pearson p. Conclusion: Th e majority of the 325 patients were African American (89%), Male (60%) and Genotype 1 (97%) with a median age of 61 years of age. Combination DAAs were used in 67% of the patients with the remaining receiving R+I+DAA. Th ere were more naïve patients in the combination DAAs group as compared to R+I+DAA group (47% vs 26% (AA); 54% vs 13% Cau). SVR for AA Genotype 1 patients receiving combination DAAs as compared to R+I+DAA was signifi cantly better (96% vs 37%; Pearson p.