Implications of Peginterferon Use in Special Populations Infected with HCV

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Abstract
Rapid progress in the treatment of hepatitis C virus (HCV) infection has led to highly successful therapies that lead to viral eradication and sustained viral response in more than 50% of patients. Despite these advances, certain identifiable subpopulations appear to have reduced rates of treatment response. These include patients co-infected with HCV/HIV, alcohol abusers, and African Americans infected with HCV. Using research tools including viral kinetic modeling, factor analysis, and laboratory evaluation of viral and host genomic characteristics, a number of key elements of response have been identified. Examination of special populations reveals that these groups comprise complex mixes of poor prognostic markers. These include both host and viral factors. Use of peginterferons with ribavirin improves response rates in these groups, but does not fully ameliorate the response deficit relative to patients enrolled in typical drug registration clinical trials.

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