Hepatitis C

In the past few months patients diagnosed with Hepatitis C have seen what had been terminal conditions be cured. The technology used to find these curative treatments can now be applied to other conditions.

"How do you move a glacier?" asked Lawrence Kosinski, MD, MBA, AGAF, FACG, managing partner of Illinois Gastroenterology Group (IGG) at the 2015 AGA Clinical Congress of Gastroenterology and Hepatology.

"There are only 2 or 3 things I know for sure. Only 2 or 3 things. That's right. Of course, it's never the same things, and I'm never as sure as I'd like to be," nuggets of wisdom (from the novel "Bastard Out of Carolina," by Dorothy Allison) that Thomas Murray, Senior Director of Quality Measurement & Improvement, AGA, shared at the 2015 AGA Clinical Congress of Gastroenterology & Hepatology.

If all goes as planned, Merck will soon take a major step forward in the hot pursuit among pharmaceutical companies to produce a newer, better, faster-working drug to treat the millions of people who have chronic hepatitis C infection.

A recent clinical trial, published in The Lancet, involving a 6-week course of a combination of 3 direct-acting oral drugs was found to cure 38 of 40 individuals with hepatitis C virus infection (HCV).

Following 2 recent studies published in Gastroenterology, researchers reported that a 24-week course of sofosbuvir and ribavirin could eliminate hepatitis C virus (HCV) infection in two-thirds of patients who undergo liver transplantation.

The spread of hepatitis C infection through the health care system continues to be a public health concern and is the subject of a review study that appeared in the December 14 issue of World Journal of Gastroenterology.

The battle over prescription exclusivity of new hepatitis C drugs continued recently when CVS Caremark revealed a new agreement with drug maker Gilead Sciences to list only Harvoni and Sovaldi on its formularies.

Express Scripts has dropped Solvaldi, Harvoni, and Olysio in favor of an exclusive deal with the drug maker AbbVie Inc. to prescribe its newly approved hepatitis C drug called Viekira Pak, according to a statement from the prescription drug-benefits management company.

The US Food and Drug Administration has announced the approval of a new combination treatment for hepatitis C virus.

Hepatitis C does not contribute to mental impairment in patients who are coinfected with HIV when there is an absence of substantial liver damage, according to a study published online in the journal Neurology.

Recent updates of guidelines for the treatment of Hepatitis C recommends priority to the sickest patients with advanced fibrosis, compensated cirrhosis or those in need of a liver transplant.

A committee for the European Medicines Agency has recommended approval for a hepatitis C drug combination, a key step to winning European marketing authorization for the drug maker AbbVie. The recommendation for marketing authorization is for AbbVie's investigational drug named Exviera (dasabuvir) and Viekirax (ombitasvir, paritaprevir and ritonavir) for the treatment of chronic hepatitis C virus infection in combination with other medicine.

The US Food and Drug Administration recently rejected a bid by Bristol-Myers Squibb to win regulatory approval for its hepatitis C drug daclatasvir, pending further information requested in a Complete Response Letter issued by the agency.

Patients who have HCV infection are at high risk for arthralgia, myalgias, pruritus, neuropathy, and decompensated livers. Until recently the sole available treatment was interferon. After the US Food and Drug Administration (FDA) approved ribavirin, patients who took ribavirin plus interferon responded better. Now, the FDA has approved a small selection of oral antivirals to treat hepatitis C.

Researchers have found that maintenance treatment with methadone or buprenorphine may help prevent hepatitis C infection among injection drug users, a population with the highest risk of infection of the virus.

Hepatitis C virus, fibrosis, and cirrhosis patients with sustained virological response can have survival rates comparable to the general population, according to research published in JAMA.

The maker of Sovriad (simeprevir) has revised the drug's package insert labeling on the order of Japanese health officials following the deaths of three people who took the hepatitis C drug.

Patients with cirrhosis who took part in a study that tested a triple combination drug for hepatitis C with ribavirin saw normalization of key laboratory tests after three and six month treatment periods, an indication of improved liver condition.

Researchers have found that maintenance treatment with methadone or buprenorphine may help prevent hepatitis C infection among injection drug users, a population with the highest risk of infection of the virus.

A liver damaged by hepatitis C virus (HCV) can be replaced by transplantation, but HCV recurs universally and, unchecked, will damage the new liver as well. Study results show a new combination of direct-acting antivirals combined with ribavirin eradicated HCV for most transplant patients with recurrent HCV genotype 1 infection and liver damage.

Three strategies for achieving one-time screening for hepatitis C virus (HCV) show variable success, but all detected more cases of HCV than current practice.

Researchers from the Mayo Clinic recently reported, at the American Association for the Study of Liver Diseases (The Liver Meeting 2014), in Boston, MA, on the safety and efficacy in post-liver transplant of 2 new oral medications, simeprevir and sofosbuvir, within a 12-week treatment span.

A screening tool that uses a common marker for liver malignancy or inflammation in combination with other values holds promise for improved screening accuracy in hepatocellular carcinoma.

New combinations of direct-acting antivirals (DAAs) may point the way to hepatitis C virus (HCV) cures without ribavirin (RBV) for some patients.

As the rapidly evolving field of hepatitis C virus (HCV) treatment progresses, clinicians can look to an expanding array of clinical trials to guide and individualize treatment decisions.

Patients who have HCV infection are at high risk for arthralgia, myalgias, pruritus, neuropathy, and decompensated livers. Until recently the sole available treatment was interferon. After the US Food and Drug Administration (FDA) approved ribavirin, patients who took ribavirin plus interferon responded better. Now, the FDA has approved a small selection of oral antivirals to treat hepatitis C.

A new clinical trial in children is set to begin that will test the blockbuster hepatitis C drug Sovaldi in combination with ribavirin as part of an all-oral regimen.

The US FDA last week approved the combo drug (trade name: Harvoni) for use in the US.

In treatment-naive patients with genotype 4 HCV, treatment with daclatasvir in combination with peginterferon alfa/ribavirin resulted in higher SVR12 rates than treatment with peginterferon alfa/ribavirin alone.