Results from a small study conducted in China suggest that a novel combination treatment could cut by 75% the treatment time of current HCV medications, which themselves cut in half the time for successful treatment only a decade ago.
A period of unprecedented advances in the treatment of hepatitis C virus (HCV) infection may have reached its zenith with news, recently reported in Science, of a small Chinese study suggesting it may be possible to cure some people of their infections in as few as 3 weeks. If duplicated and confirmed by additional research, the combination of compounds would cut by 75% the treatment time of current HCV medications, which themselves cut in half the time for successful treatment only a decade ago.
Shortening the treatment time is of significant benefit to HCV patients, who could be cured of the condition sooner, thus potentially preventing additional spread and further encouraging those who know they have the condition to be treated.
Perhaps more importantly, a shorter treatment window could mean a much lower overall cost to treat the conditionâ€‘â€‘both to patients and other healthcare payers, including Medicaid. The costs for a course of HCV treatment with newer, highly effective medications has been a vexing problem for Medicaid and an obstacle to large-scale treatment.
Data from the study will be presented at The Liver Meeting in San Francisco in mid-November. In brief, following 3 weeks of treatment, 18 HCV infected people given three different combinations of drugs met the standard definition of being cured—at 12 weeks after treatment began, they had no signs of HCV.
There are some potential caveats even before all the study data is made available. Among them is the possibility that the patients in the trial’s admittedly small sample had characteristics of patients who respond well to HCV drugs. That is, none of the trial participants had liver cirrhosis.
Yet, if further studiesâ€‘â€‘including blinded, controlled researchâ€‘â€‘can confirm the results, it would be the latest in a series of advances that could spur the end of a condition that has only been clinically established since the late 1980s. Millions worldwide remain infected and diagnosing and treating them will be an ongoing challenge. A dramatic cut in the potential treatment time, however, would be a significant advance.
The Hong Kong study tested three different triple combinations of the most effective direct-acting antivirals, each of which homes in on different HCV enzymes or proteins important to its replication. The combinations include Sofosbuvir (Gilead’s Sovaldi) and either ledipasvir or daclatasvir, which cripple a viral protein known as NS5a. Also added were one or two HCV protease inhibitors, simeprevir or asunaprevir.
Each of those drugs has a different manufacturer, so even the proven potency of a combination of all the compounds may not come to marketable fruition.