HepCInfo Updates

HepCinfo Update 8.18 

Welcome to CATIE's HepCInfo Update 8.18 for August 19 to September 1, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

New hepatitis C medication Maviret has been approved in Canada

The new hepatitis C medication Maviret has been approved for use in Canada, as an eight-week treatment for people who have never been treated before and do not have cirrhosis.

This is the first pan-genotypic eight-week treatment in Canada.

It is also approved for people who have severe kidney disease, a group of people who have not had many treatment options.

Maviret consists of two medications, glecaprevir, a protease inhibitor, and pibrentasvir, an NS5A inhibitor. The two drugs are combined into one pill, three of which are taken once per day. It is approved in Canada for people with all genotypes (1,2,3,4,5 and 6 virus).

In clinical trials of Maviret, 97% of people were cured of hepatitis C.  

For more in-depth information on Maviret, see CATIE’s TreatmentUpdate 221. (Healio.com, August 2017)

New hepatitis C medication for re-treatment, Vosevi, approved in Canada

A new hepatitis C medication, Vosevi, has been approved in Canada for people who have been previously treated but not cured. Until now, this group has had fewer treatment options.

Vosevi consists of three medications, sofosbuvir, a nucleotide polymerase inhibitor, velpastasvir, an NS5A inhibitor and voxilaprevir, a protease inhibitor. These medications are combined into one pill that is taken once per day.

 It is approved in Canada for people with all viral genotypes who have previously been treated with an NS5A inhibitor or for people with genotypes 1, 2, 3 or 4 virus who have been treated with a sofosbuvir-containing treatment that did not include an NS5A inhibitor.

In clinical trials of Vosevi, 97% of people were cured of hepatitis C.

For more in-depth information on Vosevi, see CATIE’s TreatmentUpdate 221. (Healio.com, August 2017)

In B.C., certain groups who weren’t treated as often with interferon, more likely to be treated with DAAs

In British Columbia, older people, people with HIV co-infection, people with cirrhosis and people who inject drugs have been more likely to receive direct-acting antiviral (DAA) treatments, compared to the older interferon-based treatments, reported researchers in the Journal of Viral Hepatitis.

The data came from a cohort of all people reported to have hepatitis C in B.C. between 1990 and 2013, with data on drug prescriptions up to 2015. A total of 11,886 people received treatment. As expected, given the time period of the study and the recent availability of DAAs, the vast majority (86.4%) in the cohort received an interferon-based regimen, which in some cases included boceprevir or telaprevir. About one in ten people (9.8%) received DAAs only, with a small proportion (3.6%) receiving a combination of new and old treatments.

The main analysis compared the characteristics of people who received the older interferon-based treatments (group 1) with people who received DAAs only (group 2). 

The odds of being treated with DAAs only were increased for people between 45 and 54 years (adjusted odds ratio 2.7) and people over 55 years (aOR: 15.2).

People with HIV co-infection had three times the odds of receiving DAAs (aOR: 3.0). To a lesser extent, the odds of receiving DAAs were also higher for people with cirrhosis (aOR: 1.8).

Those with a history of injection drug use had slightly higher odds of receiving DAAs (aOR: 1.3), as did people on opioid substitution therapy (aOR: 1.3).

The researchers also found that compared to people from the most-privileged neighbourhoods, the odds of receiving DAAs were lower for patients in materially deprived neighbourhoods.

According to the researchers, “these findings indicate an improvement in treatment uptake in the DAA era for population groups who were traditionally not treated with interferon-based treatments”.

Straight to the source for new science

Persistent neuropsychiatric impairment in HCV patients despite clearance of the virus?!, Journal of Viral Hepatitis, July 2017