It has been established that the hepatitis C virus genotype 1 and older age are predictors of poor response to IFN-α. Mr. C, the patient we described, was infected with hepatitis C virus genotype 1a. Dr. Rifai et al. point also to Mr. C’s African American ethnicity, obesity, and psychiatric history as predictors of poor response. The marginal effectiveness of IFN-α 2b reported in African Americans may be partly due to their being disproportionately represented among individuals with the hepatitis C virus genotype 1 (1), but viral kinetic response data indicate that IFN-α suppression of viral replication is poorer for this group (3). On the other hand, African Americans have accounted for only 5% of clinical trial populations, whereas they make up about 22% of the total hepatitis C patient population (4, 5), indicating the need for more focused research. Future research will determine precisely what benefits can be reasonably expected for African Americans who undergo a full course of treatment with pegylated IFN-α plus ribavirin. Meanwhile, we support a stance that encourages treatment of African American patients, even when they have genotype 1 infection. Viral kinetic response data also indicate that obesity may impair the effectiveness of IFN-α (2), but obesity is a modifiable factor, and there are other more compelling health reasons to encourage weight reduction.