Hepatitis C News

Hepatitis C virus infection is one of our nation’s most pressing public health concerns for infectious disease specialists and hepatologists. Not only did acute HCV infections increase 250% from 2010 to 2014, a recent report from the CDC shows that more people die of HCV in the United States than any other infectious disease, with a total 19,659 reported HCV–related deaths in 2014. Almost all of these deaths are due to the impact of chronic HCV on the liver (cirrhosis, end-stage liver disease, liver transplantation, and/or hepatocellular carcinoma or primary liver cancer).

In this issue, HCV Next asks five questions of Robert Gish, MD, who holds a number of positions, including clinical professor of Medicine (Adjunct) at the University of Nevada in Las Vegas, clinical professor of Medicine at Stanford University (Consultant) and clinical professor of Medicine, Senior Medical Director at St Joseph’s Hospital and Medical Center in Phoenix, Medical Director La Maestra, as well as leadership in National Viral Hepatitis Roundtable, Hepatitis B Foundation and Vietnam Viral Hepatitis Alliance, in addition to running his own consulting firm.

Throughout 2016, the remarkable success of direct-acting agents was confirmed and extended. Several new drugs — including Epclusa (Gilead), Zepatier (Merck), Daklinza (Bristol-Myers Squibb), Technivie (AbbVie), Viekira Pak (AbbVie) and Viekira XR (AbbVie) — were approved, representing continued remarkable potency of the DAA agents with the added bonus of extension into more pangenotypic activity. While there are still many other new drugs in development with the same trend toward increased potency and pangenotypic activity, it seems that drug development is starting to plateau. This ultimately will leave us with a strong armamentarium from which to choose the best agents for each of our individual patients.

Eight weeks of treatment with an investigational, ribavirin-free regimen of glecaprevir and pibrentasvir resulted in high rates of 12-week sustained virologic response in non-cirrhotic Japanese patients with chronic hepatitis C genotype 1 infection, AbbVie announced.

Zepatier treatment for 12 weeks, with or without ribavirin, was highly effective for induction of sustained virologic response in patients infected with hepatitis C genotypes 1, 4 or 6, who failed prior peg-interferon and ribavirin treatments, according to the results of the C-EDGE Treatment Experienced trial.

A recent cost-effectiveness analysis evaluating the value of interferon-free therapies for the treatment of hepatitis C virus infection genotype 1 revealed that administering less expensive regimens to non-cirrhotic patients and expensive yet more effective regimens to cirrhotic patients resulted in optimal outcomes for patients and insurers. Meanwhile, limiting treatment only to those with more advanced disease often resulted in poor outcomes, according to researchers.

Among patients with hepatitis C virus infection and compensated cirrhosis, achieving sustained virologic response was associated with reduced overall mortality and mortality risk related to liver- and non-liver-related complications, according to an ancillary analysis of the prospectively studied CirVir cohort.

Black and Hispanic patients with hepatitis C virus infection were less likely to achieve sustained virologic response with direct-acting antiviral agents compared with white patients within the U.S. Veterans Affairs health care system, according to recent study results.

A combination regimen of daclatasvir and asunaprevir was comparably safe and effective for treating patients with hepatitis C virus infection and renal dysfunction compared with those without renal dysfunction, according to recent Japanese study data.