Hepatitis B Clinical Research Network

描述（由申请人提供）：从我们的种族多样化数据库中招募患者参加HBCRN开发的各种自然病史和治疗试验。我们目前对慢性乙型肝炎病毒的自然史和这种疾病对治疗的反应的理解主要是在亚洲和较小程度上的高加索人群中进行的研究。这可能不能反映非裔美国人疾病的自然历史。关于非裔美国人慢性乙型肝炎病毒的自然史及其对治疗的反应，有大量的数据。解决这一知识差距非常重要，因为非裔美国人是美国慢性HBV感染的第二大常见种族/族裔群体。在HBCRN中纳入有大量非洲裔美国人的临床护理中心，对于了解慢性HBV的自然史及其对这一少数人群的治疗反应至关重要。在我们的临床护理中心，非裔美国人约占慢性HBV患者的25%，而亚洲人占不到一半。这一独特的人群将允许HBCRN测试以下假设：

DESCRIPTION (provided by applicant): To enroll patients from our racially diverse database into various natural history and treatment trials developed by the HBCRN. Our current understanding of the natural history of chronic HBV and the response of this disease to treatment has been dominated by studies conducted in Asian and to a lesser extent Caucasian populations. This may not reflect the natural history of the disease in African Americans. There is a pacuity of data regarding the natural history of chronic HBV and its response to treatment in African Americans. Addressing this gap in our knowledge is important because African Americans represent the second most common racial/ethnic group with chronic HBV infection in the USA. Including Clinical Care Centers with large African American populations in the HBCRN will be critical to understanding the natural history of chronic HBV and its response to treatment in this minority population. African Americans account for approximately 25% of patients with chronic HBV at our Clinical Care Center whereas Asians accounts for less than half of our patients. This unique population will allow the HBCRN to test the following hypotheses: Hypothesis 1: The serologic and virologic spectrum of chronic HBV in African Americans is markedly different than observed in Asians who reside in the USA. Hypothesis 2: Insulin resistence and other features of the metabolic syndrome, which are common in African Americans are associated with more severe liver injury and more rapid fibrosis progression in patients with chronic HBV. Hypothesis 3: African Americans with E-antigen (+) chronic HBV have a significantly lower seroconversion rate following treatment with peginterferon compared to non-African Americans. Hypothesis 4: Insulin resistence and other features of the metabolic syndrome, which are common in African Americans, will reduce virologic response to peginterferon but not to a potent oral antiviral agent.