HepCInfo Update 8.4
Welcome to CATIE's HepCInfo Update 8.4 for February 4, 2017 to February 17, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.
New and noteworthy
On January 17, 2017, Health Canada approved the use and sale of a point-of-care hepatitis C antibody test. It is called the OraQuick HCV Rapid Antibody Test and is produced by Orasure Technologies. It is distributed in Canada by KNS Canada. Test kits should be ready for sale by late February or early March.
The test works by checking a small drop of blood, taken from a finger prick, for antibodies to hepatitis C. It provides results in 20 minutes. The test is more than 98% accurate at detecting those antibodies.
Hepatitis C antibodies show that a person has ever had hepatitis C. Another test is needed, such as a hepatitis C RNA test or a hepatitis C core antigen test to determine if someone currently has the hepatitis C virus. (catie.ca)
A Dutch HIV pre-exposure prophylaxis (PrEP) demonstration study, AmPrEP, has found an unexpectedly high rate of hepatitis C virus in participants tested at the beginning of the study, reported researchers at the HepHIV 2017 Conference: Challenges of Timely Testing and Care.
The AmPrEP study enrolled 376 gay men and trans women at high risk of HIV infection. The study offered participants the choice of daily PrEP or on-demand PrEP. PrEP is a combination of HIV medications that people who do not have HIV can take to help prevent HIV.
The baseline prevalence of hepatitis C in participants was 4.8% (14 people), which was much higher than rates seen in a general survey of a cohort at an Amsterdam STI clinic. This hepatitis C prevalence was more typical of that seen in HIV-positive gay men rather than the much lower rates seen in HIV-negative gay men.
A genetic analysis (phylogenetic mapping) of the strains of hepatitis C virus of these AmPrEP participants was compared with the hepatitis C strains of HIV-positive men in the cohort of the Amsterdam STI clinic. Analysis showed that all but two of these 14 individuals had hepatitis C strains nearly identical to at least one other known man (HIV-positive or negative) in the clinic population.
According to the researchers, phylogenetic mapping suggests that the study participants may be more likely to have condomless sex with men of HIV-positive or unknown status because hepatitis C prevalence is higher among them than with other HIV-negative men. The researchers also recommended regular hepatitis C testing of people taking PrEP. (aidsmap.com, February 2017)
A mid-stage trial of an experimental treatment called glecaprevir/pibrentasvir (G/P) showed high cure rates for people with genotype 1 virus who needed to be retreated, reported researchers in Hepatology.
The study included 50 people without cirrhosis who have genotype 1 virus and had previously tried treatment but were not cured.
Participants were randomly assigned to one of three treatment arms for 12 weeks of once daily treatment:
- 200 mg of glecaprevir and 80 mg of pibrentasvir
- 300 mg of glecaprevir and 120 mg of pibrentasvir and 800 mg of ribavirin
- 300 mg of glecaprevir and 120 mg of pibrentasvir
In arm 1, 100% (6/6) of participants were cured. In arm 2, 95% (21/22) were cured and in arm three 86% (19/22) were cured. One participant in each of arms 2 and 3 experienced virological failure and two people in arm 3 were lost to follow up.
The researchers concluded that G/P “was highly efficacious and well-tolerated” in the study population and that the addition of ribavirin did not improve the efficacy of treatment. (hepmag.com, February 2017)
Straight to the source for new science
A practical approach to nutritional screening and assessment in cirrhosis, Hepatology, February 2017