The European Association for the Study of the Liver (EASL) / American Association for the Study of Liver Diseases (AASLD)’s two day special conference, entitled “New Perspectives in Hepatitis C Virus Infection – The Roadmap for Cure“, started today in Paris, France. The conference has gathered experts to review and analysis current hepatitis C treatment data, published and unpublished. Their focus will be on:
- Epidemiology of hep C in different areas of the world
- Virology and pathogenesis
- Natural history of the disease and impact of the new treatments on the long term consequences of chronic hep C infection
- Assessment of the disease
- Therapy, with special emphasis on difficult-to-treat populations or unsolved issues
- Eradication strategies (EASL 2016)
Some Hepatitis C Treatment Topics to be Presented in Paris (Part I)
- The treatment approach for a patient with HCV type 2 by Alessandra Mangia
Summary: This looked at clinical trial results for three Sovaldi (sofosbuvir) based treatments and possible reasons for relapse. It ruled out the idea that “…the role of a potential incorrect recognition, by the commonly used inverse dot blot genotyping method, of a chimera 2k/1b virus…” as a reason for relapse with sofosbuvir and ribavirin in genotype 2 infected patients. Because of this, it is believed that treatments in phase III studies will cure all patients with genotype 2 HCV after only 8 weeks of treatments.
- Next generation DAAs- how short can we go? by David R. Nelson
Summary: Current clinical trial data has shown success in curing in 3-4 weeks with DAA combos for “ultra-rapid responders”. As a result, it may be possible to individualize treatment times further in the future.
- Treatment of post-transplant patient by Xavier Foms
Summary: Treating post-transplant patients has become easier with the new treatments, but it still remains less than ideal because of three limitations. These limitations are: a lack of data looking at treatment without ribavirin (a drug hard to take by those with altered GFR and anemia); the increased chance of drug interactions; and lower SVR rates for patients with hep C genotype 3 virus and for those with liver cirrhosis.
- HIV-HCV Co-infection: few challenges remain by Susanna Naggie
Summary: Due to complex liver pathogenesis, higher risk of acute HCV infection and re-infection, and potential for drug interactions with antiretrovirals that are frequently not addressed in registration trials, those with HIV/HCV co-infection still pose challenges. These challenges will be looked at in this presentation.
- The treatment approach for a patient with HCV types 4-6 by Imam Waked
Summary: This abstract outlines clinical results for those with hep C genotypes 4, 5, and 6. For example, the NEUTRINO trial with Sovaldi (sofosbuvir) plus PR for 12 weeks resulted in a cure rate of 96.5% for GT4 patients and 100% cure for patients with GT5 and GT6 hep C after 12 weeks. Another trial highlight examined Zepatier for GT4 (100%) with RBV added, and GT5 (75% with RBV, 25% without RBV) and GT6 patients (SVR12 80%).
A Quote from the Conference’s Abstracts
The sweetest quote read while reading through these conference abstracts was: “Recent studies from Europe suggested that geographical factors had an impact on possible lower rates of response at the time of genotype specific treatment.” (Alessandra Mangia) Could this mean that researchers may be passed an era of genotype specific treatment and if so, will patients soon be able to follow?
Lastly, this blog post will be continued tomorrow with more information about hep C treatment currently being discussed at the EASL / AASLD special conference in Paris.