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What’s Next for HCV Next: From Approval to Nearly 100% Cure Rates, Saying Goodbye

In our very first issue of HCV Next, we covered the mere promise of new hepatitis C therapies and pledged to serve you, the prescribing physician, in the age after interferon. Today, after 5 years of doing just that, we feel that this era has come of age and our service to you comes to a close.

In this month’s editorial from co-chief medical editor Ira M. Jacobson, MD, we hear the story of the scientific evolution of HCV, from non-A, non-B hepatitis to the rise of interferon with ribavirin to the first presentations on protease inhibitors.

“Many people remember the struggle to find seats (those who tried to sit on the floor were ejected), and the hush that fell over the audience as people heard for the first time that patients were being cured permanently of this viral infection with oral antivirals that were easily tolerated,” he said. “We knew that we had entered a new era.”

When HCV Next launched, the FDA had approved just one protease inhibitor. NS5A inhibitors were waiting in the wings for their chance to shine. But everyone was ready.

“The concern is not the pace of the FDA-approval process. The concern is that patients are dying of cirrhosis and liver cancer. We now have the tools to stop this disease and end pain and suffering,” Andrew J. Muir, MD, said in our very first cover story. “We can feel better that a number of combinations are moving toward approval. We are heading toward a place where there will be different regimens, which means more options. That’s a good thing.”

Today, the presentations on HCV at The Liver Meeting focused on what our chief medical editors have deemed “the social science” of HCV. No longer are we in the process of pushing to higher cure rates with individual medications, but instead the focus is on total eradication through improved diagnosis and linkage to care.

While we covered the move from one approved medication to multiple combinations, we also covered the pressures to move to shorter and shorter durations as well as lower prices.

Now, we have generic agreements from major manufacturers and nearly perfect real-world cure rates with just 8 weeks of the lowest priced regimen. We are discussing universal screening and treating people who inject drugs.

“Over the next decade, our challenge is to comprehensively test everyone, transition those who test positive into care, treat them with affordable regimens, and then follow them appropriately based on their fibrosis status. Lastly, we should track those who are at ongoing risk for reinfection,” Michael S. Saag, MD, co-chief medical editor, said in his editorial. “Only when we put each of those pieces into consistent practice can we begin to think about elimination of HCV in the United States and around the world. With the close of this publication, the torch passes but it must be kept lit until eradication is achieved.”

Please continue to keep up on your HCV news via our other news outlets: Healio Gastroenterology and Liver Disease, Infectious Disease News and, launching soon, Healio Primary Care. You can follow along at Healio.com/HCV, Healio.com/PCT or on any of our Twitter feeds.

Thank you for allowing us to cover this race to a cure with you. – The Editors and Publishers of HCV Next