HCV update: 6 latest reports on the road to elimination

With several highly effective, curative direct-acting antiviral options for patients with hepatitis C, the focus has changed from management of the viral infection to a march toward global elimination.

Healio Gastroenterology and Liver Disease presents the following reports on the latest news in HCV including positive retreatment data for those with resistance, details of a micro-elimination program in Kentucky, and effective decentralized telemedicine.

Resistance-guided HCV retreatment achieves nearly 90% SVR

Resistance-guided direct-acting antiviral retreatment resulted in nearly 90% sustained virologic response rates among patients with hepatitis C who developed resistance-associated substitutions after failing treatment with NS5A inhibitors.

In their study, Ana Belén Pérez, from the University Hospital Reina Sofía in Córdoba, Spain, and colleagues provided indications on how to use resistance information in settings where Vosevi (sofosbuvir/velpatasvir/voxilaprevir, Gilead Sciences) may not be available. READ MORE

Africans with HCV more likely to carry ‘unusual’ genotypes, face lower SVR

Most patients with hepatitis C in Africa have genotypes outside the common and easily cured genotype 1a and genotype 1b, which has led to a suboptimal rate of sustained virologic response.

“The evidence indicates that the future desired expansion of HCV treatment in Africa may risk unacceptable rates of failure if first generation NS5A inhibitors are utilized without appropriate epidemiological and viral sequence data,” Kosh Agarwal, MD, from King’s College Hospital Trust in London, England, and colleagues wrote. “Global equity of access to curative treatment is required to avoid jeopardizing the hepatitis C elimination agenda.” READ MORE

HCV micro-elimination program seeks to cure high-risk Kentucky county

Intent Solutions announced a partnership with the University of Kentucky in a $15 million federal grant program aimed at eliminating hepatitis C in an eastern Kentucky county that has particularly high rates of chronic infection, according to a press release.

The Kentucky Viral Hepatitis Treatment Study, known as KeY Treat, is part of the contract between the company and university because the study’s design is intended to manage the dispensation of HCV medications to 900 individuals in the program. Gilead Sciences donated the medications to be used with a value of approximately $20 million. READ MORE

FDA warns about rare instances of liver injury, failure with HCV therapies

The FDA has received reports that the use of Mavyret, Zepatier or Vosevi to treat chronic hepatitis C in patients with moderate to severe liver disease has resulted in rare cases of liver injury or liver failure, according to a drug safety communication.

“While FDA-approved treatments for HCV, including Mavyret, Zepatier and Vosevi, have been widely used for many years and are safe and effective ... [it’s] important for patients and health care professionals to recognize these drugs are not indicated for use in patients with moderate-to-severe liver impairment and that there are other effective FDA-approved treatment options available for those patients with those conditions,” Debra Birnkrant, MD, from the FDA’s Center for Drug Evaluation and Research, said in a press release. “Approved HCV treatments can save lives and when prescribed as indicated, these medicines continue to be safe and effective.” READ MORE

Decentralized telemedicine achieves high HCV cure rates in rural India

Decentralized treatment of hepatitis C using telemedicine clinics achieved a sustained virologic response rate of more than 90% regardless of genotype or presence of cirrhosis, according to a published study conducted in India.

“Our strategy in Punjab is aligned with the WHO strategy on viral hepatitis elimination defined as a 90% reduction in incidence and a 65% reduction in mortality from existing levels,” Radha K. Dhiman, MD, DM, FAMS, from the Postgraduate Institute of Medical Education and Research in India, and colleagues wrote. “In addition to expanding prevention services, achieving these targets requires scaling up hepatitis treatment such that 80% of persons with chronic [hepatitis B] and HCV infection are treated.” READ MORE

PWID similarly treatable for HCV as non-PWID

Treatment outcomes for chronic hepatitis C virus infection in people who inject drugs, or PWID, and patients on opioid substitution therapy are similar to those in patients without a history of injecting drugs, according to results from a systematic review and meta-analysis published in Clinical Infectious Diseases.

The researchers noted that these findings support current guideline recommendations for treating HCV infection in these patient populations. READ MORE

With several highly effective, curative direct-acting antiviral options for patients with hepatitis C, the focus has changed from management of the viral infection to a march toward global elimination.

Healio Gastroenterology and Liver Disease presents the following reports on the latest news in HCV including positive retreatment data for those with resistance, details of a micro-elimination program in Kentucky, and effective decentralized telemedicine.

Resistance-guided HCV retreatment achieves nearly 90% SVR

Resistance-guided direct-acting antiviral retreatment resulted in nearly 90% sustained virologic response rates among patients with hepatitis C who developed resistance-associated substitutions after failing treatment with NS5A inhibitors.

In their study, Ana Belén Pérez, from the University Hospital Reina Sofía in Córdoba, Spain, and colleagues provided indications on how to use resistance information in settings where Vosevi (sofosbuvir/velpatasvir/voxilaprevir, Gilead Sciences) may not be available. READ MORE

Africans with HCV more likely to carry ‘unusual’ genotypes, face lower SVR

Most patients with hepatitis C in Africa have genotypes outside the common and easily cured genotype 1a and genotype 1b, which has led to a suboptimal rate of sustained virologic response.

“The evidence indicates that the future desired expansion of HCV treatment in Africa may risk unacceptable rates of failure if first generation NS5A inhibitors are utilized without appropriate epidemiological and viral sequence data,” Kosh Agarwal, MD, from King’s College Hospital Trust in London, England, and colleagues wrote. “Global equity of access to curative treatment is required to avoid jeopardizing the hepatitis C elimination agenda.” READ MORE

HCV micro-elimination program seeks to cure high-risk Kentucky county

Intent Solutions announced a partnership with the University of Kentucky in a $15 million federal grant program aimed at eliminating hepatitis C in an eastern Kentucky county that has particularly high rates of chronic infection, according to a press release.

The Kentucky Viral Hepatitis Treatment Study, known as KeY Treat, is part of the contract between the company and university because the study’s design is intended to manage the dispensation of HCV medications to 900 individuals in the program. Gilead Sciences donated the medications to be used with a value of approximately $20 million. READ MORE

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FDA warns about rare instances of liver injury, failure with HCV therapies

The FDA has received reports that the use of Mavyret, Zepatier or Vosevi to treat chronic hepatitis C in patients with moderate to severe liver disease has resulted in rare cases of liver injury or liver failure, according to a drug safety communication.

“While FDA-approved treatments for HCV, including Mavyret, Zepatier and Vosevi, have been widely used for many years and are safe and effective ... [it’s] important for patients and health care professionals to recognize these drugs are not indicated for use in patients with moderate-to-severe liver impairment and that there are other effective FDA-approved treatment options available for those patients with those conditions,” Debra Birnkrant, MD, from the FDA’s Center for Drug Evaluation and Research, said in a press release. “Approved HCV treatments can save lives and when prescribed as indicated, these medicines continue to be safe and effective.” READ MORE

Decentralized telemedicine achieves high HCV cure rates in rural India

Decentralized treatment of hepatitis C using telemedicine clinics achieved a sustained virologic response rate of more than 90% regardless of genotype or presence of cirrhosis, according to a published study conducted in India.

“Our strategy in Punjab is aligned with the WHO strategy on viral hepatitis elimination defined as a 90% reduction in incidence and a 65% reduction in mortality from existing levels,” Radha K. Dhiman, MD, DM, FAMS, from the Postgraduate Institute of Medical Education and Research in India, and colleagues wrote. “In addition to expanding prevention services, achieving these targets requires scaling up hepatitis treatment such that 80% of persons with chronic [hepatitis B] and HCV infection are treated.” READ MORE

PWID similarly treatable for HCV as non-PWID

Treatment outcomes for chronic hepatitis C virus infection in people who inject drugs, or PWID, and patients on opioid substitution therapy are similar to those in patients without a history of injecting drugs, according to results from a systematic review and meta-analysis published in Clinical Infectious Diseases.

The researchers noted that these findings support current guideline recommendations for treating HCV infection in these patient populations. READ MORE