Hepatic Medicine: Evidence and Research (Mar 2017)
Decreasing racial disparity with the combination of ledipasvir–sofosbuvir for the treatment of chronic hepatitis C
Abstract
Paul H Naylor , Milton Mutchnick Department of Internal Medicine/Gastroenterology, Wayne State University School of Medicine, Detroit, MI, USA Abstract: African Americans (AA) in the US are twice as likely to be infected with hepatitis C virus (HCV) compared to the non-Hispanic-white US population (Cau). They are also more likely to be infected with HCV genotype 1, more likely to develop hepatocellular carcinoma, and, in addition, have a lower response rate to interferon-based therapies. With the increase in response rates reported for combinations of direct-acting antivirals, the possibility that racial disparity would be eliminated by agents that directly inhibit virus replication has become a reality. The objective of this review is to evaluate the literature from clinical studies and retrospective analysis with respect to the response of AA to the most prescribed antiviral combination sofosbuvir plus ledipasvir. While few studies have focused on AA patients, sufficient information is availed from the literature and studies in our predominately AA clinic population to confirm that ledipasvir–sofosbuvir has a similar effectiveness in AA as compared to Cau. Keywords: hepatitis C, African Americans, ledipasvir, sofosbuvir, Harvoni, direct acting antivirals