Public Release: 

New study challenges the concept of treatment failure in hepatitis C

'Personalization' of direct-acting antiviral treatment could help eradicate hepatitis C virus from the body

European Association for the Study of the Liver

April 16, 2016, Barcelona, Spain: Data presented today demonstrate that choosing a different combination of direct-acting antiviral (DAA) treatment for Hepatitis C can eradicate the virus at four weeks in patients who had already failed on previous medication regimens.

The results were presented at The International Liver CongressTM in Barcelona, Spain and suggest that with the amount of DAAs available, the right combinations must be chosen for the right patients in order to eradicate the virus from the body.

Between 130 and 150 million people globally have chronic Hepatitis C virus (HCV) infection.1 It is estimated that 15 million people in the World Health Organization's EU Region are living with Hepatitis C, representing 2% of adults.2 Direct-acting antivirals are the treatment of choice for HCV, and these medicines have been used to treat and cure almost all patients.3,4,5,6

"As a result of the emergence of resistance associated variants, the re-treatment of patients with HCV remains challenging," said Dr Johannes Vermehren, Universitätsklinikum Frankfurt, Germany and lead author of the study. "While treatment failure was observed in all of the various medication regimens, there is hope for these patients that re-treatment with differing combinations can be effective."

The German study drew patients with failure to DAAs from a large European HCV DAA-resistance database made up of more than 3,500 patients. Patients were included if they had received interferon-free DAA regimens. Treatment combinations were specific to HCV genotype.

The study identified 310 patients with failure to direct-acting antivirals. Among patients with genotype 1 and 3, 84% and 42% had developed resistance associated variants (RAVs), respectively.

Re-treatment was started in 29% (n=57/195) of patients with genotype 1; the majority of these patients had failed treatment with the combination of simeprevir and sofosbuvir, and were re-treated with the combinations of ledipasvir and sofosbuvir or paritaprevir, ombitasvir, and dasabuvir. SVR12 was achieved in 90% of the re-treated patients with genotype 1. In the genotype 3 group, 23% (n=16/69) of patients were re-treated with sofosbuvir, daclatasvir ± ribavirin. All of the re-treated patients with available follow-up data achieved SVR12.

"The concept of failed Hepatitis C treatment may be increasingly out of date. It may indicate that we have not yet found the right combination of drugs to eradicate the virus in a particular patient. With the plethora of direct-acting antivirals available, the medical community must work to find the right combination of medicines for the right patient," said Professor Frank Tacke, member of the EASL Governing Board.

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About The International Liver Congress™

This annual congress is the biggest event in the EASL calendar, attracting scientific and medical experts from around the world to learn about the latest in liver research. Attending specialists present, share, debate and conclude on the latest science and research in hepatology, working to enhance the treatment and management of liver disease in clinical practice. This year, the congress is expected to attract approximately 10,000 delegates from all corners of the globe. The International Liver Congress™ takes place from April 13 - 17, 2016, at the Fira Barcelona Gran Via, Barcelona, Spain.

About EASL

Since EASL's foundation in 1966, this not-for-profit organisation has grown to over 4,000 members from all over the world, including many of the leading hepatologists in Europe and beyond. EASL is the leading liver association in Europe, having evolved into a major European Association with international influence, with an impressive track record in promoting research in liver disease, supporting wider education and promoting changes in European liver policy.

Contact

For more information, please contact the ILC Press Office at:

Onsite location reference

Viral hepatitis C (2), Hall 6.0
Saturday 16 April, 11:30 - 13:30
Presenter: Johannes Vermehren, Germany
Abstract: PS103, Retreatment of patients who failed DAA-combination therapies: real-world experience from a large Hepatitis C resistance database

References

1 World Health Organization. Hepatitis C Fact Sheet N°164. Available from: http://www.who.int/mediacentre/factsheets/fs164/en/. Last accessed: February 2016.
2 World Health Organization. Global Alert and Response - Hepatitis C. Available from: http://www.who.int/csr/disease/hepatitis/whocdscsrlyo2003/en/index3.html. Last accessed: March 2016.
3 1 Afdhal N, et al. Ledipasvir and sofosbuvir for untreated HCV genotype 1 infection. N Engl J Med. 2014 May 15;370(20):1889-98.
4 Afdhal N, et al. Ledipasvir and sofosbuvir for previously treated HCV genotype 1 infection. N Engl J Med. 2014 Apr 17;370(16):1483-93.
5 Kowdley KV, et al. Ledipasvir and sofosbuvir for 8 or 12 weeks for chronic HCV without cirrhosis. N Engl J Med. 2014 May 15;370(20):1879-88.
6 Sulkowski MS, et al. Daclatasvir plus sofosbuvir for previously treated or untreated chronic HCV infection. N Engl J Med. 2014 Jan 16;370(3):211-21.

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