Expert Commentary

Hepatitis C treatment in black patients: Longer isn’t better

A shorter course of treatment for hepatitis C works just as well as a longer one for black patients.

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A shorter course of treatment for hepatitis C works just as well as a longer one for black patients.

The issue: Hepatitis C rates are on the rise in America. Increases in cases of the blood-borne virus are fueled in part by injection practices linked to the nation’s ongoing opioid epidemic.

Though the incidence of hepatitis C is rising dramatically among white Americans, in general black Americans experience higher hepatitis C infection and death rates in comparison with the overall population.

In recent years a combination therapy for hepatitis C that involves two antiviral agents has increased success rates for treatment. Typically patients spend either 12 or 8 weeks on this regimen. However, guidelines produced by the American Association for the Study of Liver Diseases (AASLD) and Infectious Diseases Society for America (IDSA) indicate that black patients should not undertake the shorter course of treatment.

Researchers at Harvard Medical School and the Kaiser Permanente Division of Research sought to uncover whether these recommendations are based in scientific facts, with an eye to existing disparities that highlight how black people are less likely to receive this effective treatment.

An academic study worth reading: No Difference in Effectiveness of 8 vs. 12 Weeks of Ledipasvir and Sofosbuvir for Treatment of Hepatitis C in Black Patients,” published in Clinical Gastroenterology and Hepatology, 2018.

About the study: The researchers compared treatment responses between patients who received either 8 or 12 weeks of the combination antiviral agents ledipasvir and sofosbuvir. The study involved 6,108 people with hepatitis C. For this study, certain black patients were eligible to receive 8 weeks of therapy because the research was conducted before the AASLD/IDSA guidelines included a race criterion. The researchers compared the efficacy of the different lengths of treatment overall and by subgroups, including race and ethnicity.

Key findings:

  • “Among black patients eligible for 8 weeks, we found no difference in treatment response between those treated for 8 and 12 weeks.”
  • Race was not linked to treatment failure.
  • The authors recommend wider adoption of 8-week regimens, suggesting this is an effective and more affordable treatment option.

Other resources:

  • MedlinePlus, a National Institutes of Health-sponsored initiative, offers an overview of the hepatitis C virus.
  • The National Institute of Diabetes and Digestive and Kidney Diseases also has information on the virus.
  • The U.S. Centers for Disease Control and Prevention offer statistics on cases of hepatitis C nationwide.

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