HepCInfo Updates

HepCInfo Update 7.9 

Welcome to CATIE's HepCInfo Update 7.9 for April 16 to April 29, 2016. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

DAAs as effective in real world settings as in clinical trials

Hep C treatment with direct-acting antivirals (DAAs) is as effective in real world settings as it is in clinical trials, reported researchers at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) in Barcelona. 

While there are many clinical trials of DAAs that have demonstrated cure rates above 90%, there is limited data on the effectiveness of DAAs in the real world.

This real world study included the records of over 9,000 people from U.S. Veterans Affairs who had completed treatment with a DAA combination and were followed for an additional 12 weeks to see if they had been cured.

Participants took one of the following treatments:

The majority of the participants were male (96%) between the ages of 60 and 65 years (65%) and 75% had genotype 1 virus.

The cure rates were high for all three DAA combinations:

  • Simeprevir + sofosbuvir: 87.3%
  • Harvoni: 93.2%
  • Holkira Pak: 93.4%

After controlling for baseline characteristics, people taking Harvoni or Holkira Pak were significantly more likely to be cured than people taking simeprevir plus sofosbuvir.

The researchers concluded that the use of DAA combinations in routine settings has been found “to fulfill their promise of greater than 90% [cure rates] as first documented in randomized clinical trials.” (HIVandhepatitis.com, April 2016, in English)

Six weeks of Harvoni cures acute Hep C

Harvoni taken for six weeks cured all patients with acute Hep C infection with genotype 1 virus, reported researchers at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) in Barcelona. 

There are currently no direct-acting antiviral (DAA) medications approved to treat acute Hep C infection.

The study enrolled 20 participants from 10 treatment centres in Germany between November 2014 and October 2015. People with Hep C and HIV co-infection were not included. The participants were mostly men and the average age of the group was 46 years.

All participants were treated with Harvoni without ribavirin for six weeks. Harvoni is a combination of two DAAs, ledipasvir and sofosbuvir. They are combined into one pill that is taken once per day.

Everyone completed treatment and was cured. Treatment was generally safe and well tolerated. The most common side effects were gastrointestinal symptoms, fatigue and hair loss.

"Short treatment of only six weeks was highly effective with an SVR12 rate of 100% in acute HCV genotype 1 mono-infected patients," the researchers concluded. (HIVandhepatitis.com, April 2016, in English)

High Hep C re-infection rate among HIV-positive gay men in Western Europe

There is a very high incidence of Hep C re-infection among HIV-positive gay men in Western Europe, reported researchers at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) in Barcelona. 

One-quarter of HIV-positive gay men who cleared an initial Hep C infection were re-infected within three years.

The study included 606 HIV-positive gay men with a confirmed cure or spontaneous clearance of Hep C.

Over 3 years of follow-up, 149 participants (24.6%) were reinfected with HCV. The mid-range of time to reinfection was 1.8 years. Of the people with available data, most (91 of 111) had an undetectable HIV viral load at the time of re-infection.

A second re-infection was recorded in 29 participants, four people were re-infected three times, and one person had four re-infections.

Overall rate of infection in this study was over 7% of participants infected per year. The incidence of second re-infection was just under 20% per year.

The investigators concluded that there is a substantial risk of Hep C re-infection for HIV-positive men who have sex with men. They believe their results show the failure of current prevention interventions and underline the need for new strategies. The researchers also called for Hep C RNA testing to be performed every three to six months after Hep C infection and every three months after re-infection. (HIVandhepatitis.com, April 2016, in English)

Straight to the source for new science

Public health clinic-based hepatitis C testing and linkage to care in Baltimore, Journal of Viral Hepatology, May 2016, in English

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