Cooper Curtis L, Bailey Robert J, Bain Vince G, Anderson Frank, Yoshida Eric M, Krajden Mel, Marotta Paul
University of Ottawa, Ottawa Health Research Institute, The Ottawa Hospital, Ottawa, Ontario.
Can J Gastroenterol. 2008 Aug;22(8):677-80. doi: 10.1155/2008/320150.
There is little published information on baseline characteristics and therapeutic outcomes in hepatitis C virus (HCV)-infected Aboriginal Canadians. It is unclear what proportion of HCV-infected Aboriginal people receive therapy relative to other populations.
Adults with chronic HCV infection, quantifiable serum HCV-RNA levels and compensated liver disease were assigned, at the physician's discretion, to either 24 or 48 weeks of treatment with peginterferon alpha-2a 180 mug/week plus ribavirin at a dose of 800 mg/day, or 1000 mg/day or 1200 mg/day in an open-label, expanded access program. The primary outcome was sustained virological response, defined as undetectable HCV-RNA by qualitative polymerase chain reaction (less than 50 IU/mL) at the end of 24 weeks of untreated follow-up. Baseline characteristics and outcomes in Aboriginal and non-Aboriginal patients were compared.
A total of 2614 patients were eligible for the analysis; 44 individuals (1.7%) self-identified as being of Aboriginal heritage. The baseline characteristics of these two groups were similar. An overall sustained virological response was achieved in 47.7% and 46.5% of Aboriginal and non-Aboriginal patients, respectively. The overall frequencies of adverse events and laboratory abnormalities were similar between the two groups, although cytopenias occurred less frequently in Aboriginal patients.
Aboriginal patients were greatly under-represented in the present 'community'-based treatment program, yet viral responses were similar to those of a non-Aboriginal cohort. To increase the uptake of HCV therapy in the Aboriginal population, clarification of the obstacles to treatment is warranted.
关于加拿大原住民丙型肝炎病毒（HCV）感染者的基线特征和治疗结果，公开信息较少。目前尚不清楚与其他人群相比，接受治疗的HCV感染原住民比例是多少。
在一项开放标签的扩大准入项目中，由医生自行决定，将患有慢性HCV感染、血清HCV - RNA水平可量化且肝功能代偿的成年人，分配接受24周或48周的聚乙二醇干扰素α - 2a（180微克/周）联合利巴韦林治疗，利巴韦林剂量为800毫克/天、1000毫克/天或1200毫克/天。主要结局为持续病毒学应答，定义为在未经治疗的24周随访结束时，通过定性聚合酶链反应检测不到HCV - RNA（低于50国际单位/毫升）。比较了原住民和非原住民患者的基线特征及治疗结果。
共有2614例患者符合分析条件；44例（1.7%）自我认定为有原住民血统。两组的基线特征相似。原住民和非原住民患者的总体持续病毒学应答率分别为47.7%和46.5%。两组不良事件和实验室异常的总体发生率相似，不过原住民患者血细胞减少的发生率较低。
在目前这个基于“社区”的治疗项目中，原住民患者的比例严重偏低，但病毒学应答与非原住民队列相似。为提高原住民人群对HCV治疗的接受度，有必要明确治疗的障碍。
