Miami Herald - January 14, 2009
Fred Tasker, ftasker@MiamiHerald.com

Hispanics of all nationalities respond less well to the current standard drug treatment for hepatitis C than do non-Hispanic whites, according to a new study led by University of Miami Medical School experts. Doctors don't know why.

The study echoes the results of a 2006 study that said blacks also respond less well.

"There's something different about their makeup, either genetic or immunological, that makes the virus respond less to the medication. We don't know the exact mechanism," said Dr. Lennox Jeffers, professor of medicine at UM and a principal investigator of the study. The study is published in the Jan. 15 issue of The New England Journal of Medicine.

In it, 269 Hispanics and 300 non-Hispanic whites were given standard treatment of 48 weeks of pegylated interferon, brand name Pegasus, with ribavirin. About 30 of the Hispanics in the multi-hospital study were from South Florida.

The difference was significant: About 50 percent of non-Hispanic whites responded to the medical treatment compared to only 33 percent of Hispanics, Jeffers said.

Careful controls in the study ruled out such social causes as lack of compliance with drug regimes or failing to take the pills, Jeffers said.

One problem in developing and approving such drugs is that Hispanics and blacks have been under-represented in clinical trials, he said.

The two groups are much-better represented in new research into adding protease inhibitors such as telapravir and bocepravir as third drugs to the cocktail fighting hepatitis C -- similar to drug cocktails given to patients with HIV, Jeffers said.

The coming of such new drugs brings new hope to patients with hepatitis C, said Dr. Paul Martin, chief of hepatology at UM Medical School and senior author of the study. Overall cure rates with current drugs is about 50 percent, he said. He expects it to reach 60 percent in two years with the new three-drug cocktail, and 70 percent or more with new oral drugs within three to five years.

Whether the response of Hispanics and blacks will be as good is yet to be seen, he said.

"This study clearly shows that this is a difficult virus to overcome in Hispanics, and we need to figure out why."

On the Net:

New England Journal of Medicine
Peginterferon Alfa-2a and Ribavirin in Latino and Non-Latino Whites with Hepatitis C

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