HepCInfo Updates

HepCInfo Update 9.2  

Welcome to CATIE's HepCInfo Update 9.2 for January 6 to January 19, 2018. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

High hepatitis C cure rates with Harvoni in people with HIV and acute hepatitis C

An eight-week course of Harvoni cured 100% of participants with acute hepatitis C and HIV in a small study, reported American researchers at the AASLD Liver Meeting, in Washington, DC.

Acute hepatitis C is defined as the first six months after a person acquires hepatitis C. It is generally easier to treat than chronic hepatitis C infection.

Some studies have found that acute hepatitis C can be cured with direct-acting antiviral (DAA) treatment in six or eight weeks in people who only have hepatitis C.

In people with HIV/hepatitis C coinfection, treating for six weeks produced high relapse rates. Some experts recommend treatment people with coinfection for 12 weeks.

This study sought to find out if eight weeks of treatment with Harvoni (ledipasvir and sofosbuvir) would be effective in people with HIV and hepatitis C.

The study include 27 HIV-positive American participants with acute hepatitis C. All participants were men, with a mid-range in age of 46 years. Two-thirds of participants were white and a third were Hispanic. All participants were taking HIV treatment and had an undetectable viral load.

All had HCV genotype 1, except one person with genotype 4. Treatment was generally safe and well tolerated.

According to the researchers, "These data support an eight-week duration of [[sofosbuvir/ledipasvir] in the treatment of acute HCV infection in HIV-infected persons." (infohep.org, November 2017)

Hepatitis C treatment is effective in people with HIV who have factors that are difficult to treat

A real life study of the effectiveness of hepatitis C treatment in people with HIV who have cirrhosis or who have been previously treated had cure rates of 93%, reported Spanish researchers in AIDS.

In the past people with HIV and hepatitis who had cirrhosis or had previously been treated for hepatitis C were less likely to be cured.

Researchers analysed outcomes in 515 people with HIV and hepatitis C co-infection who started a direct-acting antiviral (DAA) treatment in 2015.

The participants had a median age of 50 years and 78% were male. Just over half (54%) had cirrhosis and 46% had been previously treated for hepatitis C but not cured.  

The majority of participants (95%) were taking HIV treatment and their HIV was well-controlled.

Over half of participants (57%) were treated with Harvoni (ledipasvir and sofosbuvir). Just over a third of people (37%) were treated with the addition of ribavirin to their regimen and seven percent took a 24-week course of therapy.

Participants with cirrhosis had a cure rate of 87.5%. Treatment was generally well tolerated, although people who took ribavirin experienced more side effects.

According to the researchers, “In real-life conditions, difficult-to-treated HIV/HCV-co-infected patients treated with all-oral DAA combinations reach high [cure] rates… similar to those achieved by mono-infected patients in such conditions,” (infohep.org, January 2018)

Smoking lowers survival after a liver cancer diagnosis in people with hepatitis B or C

People with hepatitis B or C who smoked were three times more likely to die after being diagnosed with liver cancer, reported Swiss researchers in Liver International.

Non-smokers lived for a mid-range of 3.2 years after a liver cancer diagnosis whereas smokers died after a mid-range of 18 months.

To look at the effect of continuing to smoke after a diagnosis of primary liver cancer, Swiss researchers analysed survival in 238 people with hepatitis B or C who had at least 12 months of follow-up after diagnosis of liver cancer.

Sixty-four people reported smoking at the time of inclusion in the study. Smokers were followed for a mid-range of 489 days and non-smokers were followed for 1170 days. People who smoked were followed for less time because of poorer survival.

Liver cancer developed at a younger age in smokers (59 vs 66 years).

After controlling for potential confounders, an analysis showed that smoking was linked to just over a two-fold greater risk of dying in people with viral hepatitis diagnosed with liver cancer.

According to the researchers, “Based on these findings, smoking cessation should be considered for incorporation into the disease management for patients with hepatitis B or C [with liver cancer],” (infohep.org, January 2018)

Straight to the source for new science

Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C: a qualitative study of client and provider relationships, Harm Reduction Journal, November 2017