HepCInfo Updates

HepCInfoUpdate 7.20 

Welcome to CATIE's HepCInfo Update 7.20 for October 15 to October 30, 2016. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

Response guided DAA treatment may cure hepatitis C in three weeks

In a small mid-stage trial of people with genotype 1b virus the majority of participants were cured with a triple combination of direct acting antiviral (DAA) medications, reported researchers in The Lancet Gastroenterology and Hepatology.

The Hong Kong-based trial included 26 participants with minimal or no liver injury.

Participants were treated with a combination of three of the following DAAs:

Participants with ultra-rapid response, defined as hepatitis C RNA decreasing to less than 500 IU/mL by day two of treatment stopped treatment after three weeks. Participants without an ultra-rapid response were switched after day two to Harvoni (sofosbuvir and ledipasvir) for eight to 12 weeks.

At day two of treatment, 69% of participants reached ultra-rapid response. All of these participants were treated for three weeks and cured. People who had ultra-rapid response had a lower baseline viral load on average.

Treatment was generally safe and well tolerated. The most common side effects were fatigue and headache.

These results suggest that shortening treatment to three weeks may be adequate for some easy-to-treat participants. The researchers recommend further trials on larger groups of people. (HIVandhepatitis.com, October 2016)

Generic hepatitis C medications purchased online have high cure rates

Generic version of direct acting antivirals produced high cure rates in people with hepatitis C who obtained the drugs through three buyer’s clubs, reported researchers at the International Congress on Drug Therapy in HIV Infection.

Some people are choosing to purchase generic hepatitis C medications from other countries when they cannot get access to them in their home country. These generic medications are usually produced in India or Bangladesh and are available at a reduced cost. In some countries, it is legal to import drugs for personal use by buying them online or by travelling to the country of production and bringing them back.

This study focussed on 438 people who had purchased hepatitis C medication through the FixHepC buyer’s club. During the study the medications were tested for active ingredients of the medication and participants were monitored.

Participants took one of three treatments: sofosbuvir and ribavirin, sofosbuvir and daclatasvir or sofosbuvir and ledipasvir.  

The majority of participants had moderate or no liver injury (59%), 11% had advanced liver injury and 27% had severe liver injury (cirrhosis).

Overall, 90% of people who purchased medications through the FixHepC buyer’s club and completed 12 weeks of post-treatment follow up were cured. Participants with genotype 3 virus were less likely to be cured from treatment (80% cure rate).

The study also examined treatment results from buyer’s clubs in Southeast Asia, and Russia and Eastern Europe and found cure rates between 81% and 100%.

The researchers recommend longer term follow-up of these participants to produce stronger estimates of those cured through treatment and any differences by viral genotype. (HIVandhepatitis.com, October 2016)

Hepatitis C reinfection high among HIV-positive European gay and bisexual men

A large retrospective study of HIV-positive gay and bisexual European men found that just over 7% per year were reinfected with hepatitis C per year reported researchers in the Journal of Hepatology.

The participants were from eight clinical centres that are part of the European AIDS Treatment Network (NEAT). The participants’ data were drawn from 2002 to 2014.  

Of the 606 participants who had previously had hepatitis C and had either spontaneously cleared or received treatment, 149 (24.6%) had a subsequent hepatitis C reinfection.

Of those, 30 out of 70 (43%) who cleared again or who were treated and cured had a second reinfection. Five of these people had a third infection and one had a fourth reinfection. 

The mid-point duration to reinfection was two years.

The researchers recommend that “HIV-positive men who have sex with men with a prior hepatitis C infection should be tested every three to six months for reinfection, [and] those who had achieved a reinfection [should be tested] every three months.” (Healio.com, October 2016)

Straight to the source for new science

Facilitators of HCV Treatment Adherence among People Who Inject Drugs: a Systematic Qualitative Review and Implications for Scale up of Direct Acting Antivirals, BMC Public Health, September 2016

Harm reduction workers and the challenge of engaging couples who inject drugs in hepatitis C prevention, Drug and Alcohol Dependence, 2016