New treatments show promise in hardest-to-treat hepatitis C cases

New studies show promise in treating the most difficult cases of hepatitis C with shorter, more effective treatment alternatives that have fewer side effects.

According to the new studies, both of which focus on treating hepatitis C genotype 1-the most common genotype in the U.S., Europe, North Asia, Australia and South America, and the most difficult to treat, a press release from The Lancet said.

Approximately 150 million people around the world have chronic hepatitis C, which is a major cause of liver cirrhosis and liver cancer. Due to low treatment rates, the number of people with the hepatitis C-related liver failure and liver cancer is expected to triple by 2030.

The standard treatment for chronic hepatitis C genotype 1 involves a three-drug cocktail: ribavirin, pegylated interferon (PEG) and a protease inhibitor, which prevent the virus from replicating and boost the body's immune response.

Traditional medication therapies, however, can be burdensome to the patient. Some patients may be required to take up to 18 pills every day for up to a year. Conventional treatments can also cause a number of severe side effects, including anemia and depression.

In one of the studies, a group of patients received six months of treatment with a pair of oral direct-acting antiviral agents (DAA)-asunaprevir and daclatasvir. The study showed the treatment was highly effective at eliminating the virus and well-tolerated even by patients who have been hardest to treat.

In the second study, a group of patients received a 12-week or 24-week course of once-daily sofosbuvir and simeprevir with or without ribavirin.

After 12 weeks of treatment, 93 percent of patients were cured, with no detectable virus in their blood three months after the stop of treatments. Extending the treatment to 24 weeks or adding ribavirin did not produce a clear benefit.

"In the future, very-short-duration, all-oral DAA regimens should improve treatment uptake and success, and reduce the health burden from liver-related complications," Ed Gane, the director of the New Zealand Liver Transplant Unit at Auckland City Hospital in New Zealand, said. "When combined with targeted testing and treatment of populations who transmit infection (ie, treatment as prevention), these DAA regimens might eventually eliminate HCV infection. The only barrier to achieving this goal will be the ability to access these new therapies."