HepCInfo Updates

HepCInfo Update 9.15  

Welcome to CATIE's HepCInfo Update 9.15 for July 7 to July 20, 2018. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

We sometimes report on experimental use of hepatitis C drugs. For information on the approved use of hepatitis C treatment in Canada, see the Hepatitis C drugs approved in Canada for adults chart and fact sheets on each hepatitis C treatment.

New and noteworthy

Hepatitis C-related liver transplants are decreasing
 
The number of liver transplants due to hepatitis C-related liver failure and liver cancer has decreased rapidly and the survival of people post-liver transplant has improved in Europe, reported researchers in Hepatology.
 
In order to examine the impact of direct-acting antiviral medications (DAAs) on hepatitis C-related liver transplants (LT), the researchers analyzed data on liver transplants in three time periods:

  • 2007-2010: when the only treatment was interferon and ribavirin
  • 2011-2013: when peg-interferon became available
  • 2014-2017:when DAAs became available

 The data came from 12,469 participants in the European Transplant Registry who had hepatitis C and a liver transplant between January 2007 and June 2017.
 
Among the participants, liver transplants were for liver failure in 72% of the group and for liver cancer in 28% of the group. From the interferon era to the DAA era, hepatitis C decreased as an indicator for LT from 23% to 17%. Liver failure also decreased during these eras from 13% to 8%. Liver cancer remained stable as an indicator (9.5% vs 9.4%).
 
The three-year survival rate in people with hepatitis C who received liver transplants improved from 65% in the interferon era to 77% in the DAA era.
 
According to the researchers, “This is the first large scale study demonstrating that the survival of LT recipients with hepatitis C-related liver disease has dramatically improved over the last three years, being currently comparable to the survival of recipients with hepatitis B infection.” (Healio. com, June 2018)
 
Epclusa effective in people with genotype 1, 2, 3 and 4 virus post-liver transplant
 
People who had a liver transplant and hepatitis C 1, 2, 3 or 4 virus had high cure rates when treated with Epclusa, reported researchers in Hepatology.
 
The study included 79 people who were treated post-liver transplant with Epclusa for 12 weeks. Epclusa consists of two direct-acting antiviral medications, sofosbuvir and velpatasvir, which are co-formulated into one pill that is taken once per day.
 
The majority of participants were white (82%) and male (81%).
 
The majority of people had genotype 1 virus (37) or genotype 3 virus (35). Three people had genotype 2 virus and four people had genotype 4 virus. Also, 14 people had advanced liver injury and 47 people had previously been treated.
 
The overall cure rate was 97%. Treatment was well tolerated and no Epclusa-related adverse events occurred.

All people who receive an organ transplant must take medications that suppress their immune system for the rest of their lives so their bodies don’t reject the new organ. Treatment with Epclusa did not impact these medications. No liver transplants were rejected during treatment.

According to the researchers, “Treatment with [Epclusa] for 12 weeks was highly effective and well tolerated in genotype 1–4 hepatitis C-infected liver transplant recipients with and without cirrhosis.” (Healio.com, June 2018)

Straight to the source for new science

Awareness and knowledge of hepatitis C among health care providers and the public: A scoping review, Canada Communicable Disease Report, July 2018

Barriers to and facilitators of hepatitis C virus screening and testing: A scoping review, Canada Communicable Disease Report, July 2018