The proposed project is a 5-year multicenter open-label trial designed to evaluate the efficacy of 40 kDa Pegylated interferon alfa-2a (Peginterferon alfa-2a) in combination with Ribavirin in the treatment of genotype-1 chronic hepatitis C (HCV, genotype-1) in African American men and women as compared to non-Hispanic whites. The Primary Aim of this proposal is to establish rates of sustained virologic response to a 48-week course of Peginterferon alfa-2a in combination with ribavirin in African Americans as compared to non-Hispanic whites with chronic HCV genotype 1 as assessed at the end of 48-week post-treatment follow-up by HCV RNA (<25 IU/mL). As Secondary Aims, we will assess biochemical markers of response to treatment [e.g., normalization of alanine aminotransferase (ALT)], specific patterns of early (e.g., early vs. no response over a 28-day period) and longitudinal (i.e., weeks 12 24, 36, 48 of treatment and week 24 post-treatment) response patterns, as well as, hepatic histology activity index (HAI), Body Mass Index (BMI) and demographic (e.g., age, gender, education, income level) and psychosocial factors (e.g., depression, anxiety, social support, coping) associated with treatment response and adherence.
The Specific Aims of this project are as follows: PRIMARY AIM:
SPECIFIC AIM 1. To establish rates of sustained virologic response to a 48-week course of Peginterferon alfa-2a in combination with ribavirin in African Americans as compared to non- Hispanics whites with chronic HCV genotype 1 as assessed at the end of 48-week post-treatment follow-up by HCV RNA (<25 IU/mL). SECONDARY AIMS:
SPECIFIC AIM 2. To establish rates of sustained biochemical response to a 48-week course of Peginterferon alfa-2a in combination with ribavirin in African Americans as compared to non- Hispanic whites with chronic HCV genotype 1 as assessed at the end of 48-week post-treatment follow-up by serum ALT.
SPECIFIC AIM 3. To determine patterns of longitudinal response or non response (i.e., weeks 12, 24, 36, 48 and 24 weeks post-treatment) of Peginterferon alfa-2a in combination with Ribavirin on: a) viral load (HCV RNA) alone; b) serum ALT alone; and c) combined HCV RNA and serum ALT.
SPECIFIC AIM 4. To determine patterns of early (i.e., within a 28-day period) virologic response or non- response following Peginterferon alfa- 2a in combination with Ribavirin.
SPECIFIC AIM 5. To evaluate changes in histology as determined by HAI by comparison of liver biopsy findings pre-treatment (within 12months prior to study initiation) and at the end of the 48-week post-treatment observation period.
SPECIFIC AIM 6. To correlate end of treatment and sustained virologic response with baseline HAI, BMI and compliance to treatment.
SPECIFIC AIM 7. To identify sociodemographic (e.g., age, education income, gender, ethnicity) and psychosocial (e.g., anxiety, depression, coping) predictors of adherence to treatment and virologic response to HCV RNA.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01DK060352-05
Application #
6896114
Study Section
Special Emphasis Panel (ZDK1-GRB-6 (M1))
Program Officer
Robuck, Patricia R
Project Start
2001-08-21
Project End
2006-04-30
Budget Start
2005-05-01
Budget End
2006-04-30
Support Year
5
Fiscal Year
2005
Total Cost
$156,262
Indirect Cost
Name
University of Miami School of Medicine
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
052780918
City
Miami
State
FL
Country
United States
Zip Code
33146
Jin, Runyan; Cai, Ling; Tan, Ming et al. (2012) Optimum ribavirin exposure overcomes racial disparity in efficacy of peginterferon and ribavirin treatment for hepatitis C genotype 1. Am J Gastroenterol 107:1675-83
Howell, Charles D; Gorden, Alexis; Ryan, Kathleen A et al. (2012) Single nucleotide polymorphism upstream of interleukin 28B associated with phase 1 and phase 2 of early viral kinetics in patients infected with HCV genotype 1. J Hepatol 56:557-63
Golden-Mason, Lucy; Bambha, Kiran M; Cheng, Linling et al. (2011) Natural killer inhibitory receptor expression associated with treatment failure and interleukin-28B genotype in patients with chronic hepatitis C. Hepatology 54:1559-69
Evon, Donna M; Esserman, Denise A; Ramcharran, Darmendra et al. (2011) Social support and clinical outcomes during antiviral therapy for chronic hepatitis C. J Psychosom Res 71:349-56
Conjeevaram, Hari S; Wahed, Abdus S; Afdhal, Nezam et al. (2011) Changes in insulin sensitivity and body weight during and after peginterferon and ribavirin therapy for hepatitis C. Gastroenterology 140:469-77
Evon, Donna M; Ramcharran, Darmendra; Belle, Steven H et al. (2009) Prospective analysis of depression during peginterferon and ribavirin therapy of chronic hepatitis C: results of the Virahep-C study. Am J Gastroenterol 104:2949-58
Yee, L J; Im, K; Borg, B et al. (2009) Interleukin-6 haplotypes and the response to therapy of chronic hepatitis C virus infection. Genes Immun 10:365-72
Hoofnagle, Jay H; Wahed, Abdus S; Brown Jr, Robert S et al. (2009) Early changes in hepatitis C virus (HCV) levels in response to peginterferon and ribavirin treatment in patients with chronic HCV genotype 1 infection. J Infect Dis 199:1112-20
Mengshol, J A; Golden-Mason, L; Castelblanco, N et al. (2009) Impaired plasmacytoid dendritic cell maturation and differential chemotaxis in chronic hepatitis C virus: associations with antiviral treatment outcomes. Gut 58:964-73
Dove, Lorna M; Rosen, Raymond C; Ramcharran, Darmendra et al. (2009) Decline in male sexual desire, function, and satisfaction during and after antiviral therapy for chronic hepatitis C. Gastroenterology 137:873-84, 884.e1

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