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Elizabeth Boskey, Ph.D.

Hepatitis C - Seeing a Cure?

By March 12, 2012

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At the Conference for Retroviruses and Opportunistic Infections last week, some of the most exciting data came from Phase II studies examining the use of hepatitis C specific protease inhibitors to clear the virus in HIV co-infected patients. Results of the studies were very positive, although there was some concern about drug-drug interactions with some of the standard protease inhibitors used to treat HIV. Still, experts in the field were generally positive, and ongoing phase III trials will hopefully lead to the approval of these drugs for use in HIV infected patients over the next few years.

I don't spend a lot of time writing about Hepatitis C, since it is generally a bloodborne infection instead of a sexually transmitted one, so I'm slightly embarrassed to admit that the existence of these drugs was news to me. However, it turns out that they've already been shown to be highly effective at eradicating hepatitis C genotype-1 in HIV negative patients. They don't work for everyone, but they are a significant improvement over previous options.

Speaking of hepatitis C in HIV-negative patients, one preliminary study released at CROI had particularly good news for those who have had problems with other treatments. The research, presented by Dr. Edward Gane of the Auckland City Hospital in New Zealand, found that 100 percent of genotype-1 patients who had not responded to the standard treatment of pegylated interferon plus ribavirin did have a rapid virologic response to the HCV nucleotide analogue PSI-7977 (now GS-7977), in combination with ribavirin -- and all had an undetectable viral load after 4 weeks. Although virus levels rebounded after cessation of treatment, this was still excellent news for the group of patients who have had no success on current treatments - particularly as the all oral regimen was tolerated significantly better than interferon including regimens usually are. Treatment naive patients with genotypes 1, 2, and 3 also achieved viral suppression on the drug.

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