2017-HCV Genotypes/Treatment

News And Research

2017-HCV Genotypes/Treatment
Offered on this page is research updates with a focus on treating HCV according to genotype using FDA approved and investigational medicines. Information is extracted from news articles, peer-reviewed journals, as well as liver meetings/conferences, research manuscripts and interactive learning activities. 

January 2017
If case you missed it ..... two articles worth reading
The Treatment of Hepatitis C- An Introduction to the Use of New Medicines.

February 2017
New and Updated HCV Treatment Fact Sheets Now Online
New fact sheets include; HCV Genotypes, Epclusa and an updated fact sheet on Viekira XR and Technivie.

Liver Health
The Liver Loving Diet - A Must Read For People With HCV Or Liver Disease
Recommended treatments for chronic hepatitis C genotypes 1-6
PDF - Treatment of HCV Genotype 1
PDF - Treatment of HCV Genotype 2
PDF - Treatment of HCV Genotype 3
PDF - Treatment of HCV Genotype 4
PDF - Treatment of HCV Geno 5 or 6.
Source - Hepatitis C Online

Treating HCV according to genotype
News Archive

2017 February
Feb 24
Genotype 3
Hepatitis C Virus in mainland China with an emphasis on genotype and subtype distribution
The associations between HCV GTs and patients group, severity of illness and antiviral treatment efficacy were also discussed in this review

Feb 22
Ontario Becomes First Province To List EPCLUSA™ On Public Drug Plan To Treat All Six Genotypes Of Chronic Hepatitis C Infection
Deal reduces price of life-saving hepatitis C drugs for Canadians
The list cost to the health system for hepatitis C treatment has ranged from $45,000 to over $100,000 per patient, depending on the drug and disease progression.  Agreements with the pCPA were reached with Gilead Sciences Canada, Merck Canada, and Bristol-Myers Squibb Canada to provide several hepatitis C drugs at an improved cost:
Daklinza (daclatasvir) – new
Epclusa (sofosbuvir/velpatasvir) – new
Harvoni (ledipasvir/sofosbuvir)
Sovaldi (sofosbuvir)
Sunvepra (asunaprevir) – new
Zepatier (elbasvir/grazoprevir) – new

PharmaCare is expanding the criteria in March 2017 to provide coverage to more patients living with hepatitis C. Physicians can apply for coverage of the new drugs on behalf of their patients on or around March 21, 2017. Starting in 2018-19, PharmaCare will provide coverage for any British Columbian living with chronic hepatitis C, regardless of the type or severity of their disease
Read it here.....

Download Accepted Article
Genotype 3
HIV infected & uninfected adults with non–GT 3 HCV have less hepatic steatosis than adults with neither infection

Feb 21
Direct-acting combination antiviral therapies expected to be approved in 2017
Novel emerging treatments for hepatitis C infection: a fast-moving pipeline
This update reviews some upcoming therapies for the treatment of chronic hepatitis C

Genotype 1
HCV Genotype 1 No Longer a Treatment Bugbear
Treating patients with genotype 1 hepatitis C (HCV) can be rewarding because of a simple fact: modern direct-acting agents (DAAs) have a nearly 100 percent cure rate. Yet only four years ago, genotype 1 was considered the most difficult-to-treat type of HCV.
Back then, interferon regimens were used, and cure rates for genotype 1 hovered around 50 percent, while genotypes 2 and 3 were considered better treatment successes stories.

Feb 16
Pan-genotypic Treatment Regimens for Hepatitis C Virus: Advantages and Disadvantages in High- and Low-income Regions
This review examines the challenges of developing pan-genotypic HCV direct-acting antiviral regimens, focusing on the context of regional differences in HCV genotype and socioeconomic factors.

Feb 12
Case Report
Mixed Genotype 1 and 2
Successful Treatment of Mixed Hepatitis C Genotypes in a Cirrhotic Patient With an All-Oral, Interferon-Free Regimens
We present a case of mixed HCV genotype 1a and 2 infection in a decompensated cirrhotic patient treated successfully with sofosbuvir, ledipasvir, and ribavirin.

Feb 9
Genotype 3
Accepted manuscript online:
Daclatasvir+Sofosbuvir, With or Without Ribavirin, for HCV GT 3 in a French Early Access Programme
DCV+SOF achieved high SVR12 rates and was well tolerated in this large real-world cohort of GT3-infected patients with advanced liver disease, without benefit of ribavirin in those treated 24 weeks.

Of Interest
Generic ledipasvir-sofosbuvir for patients with chronic hepatitis C: a real-life observational study

Feb 8
All Genotypes
New HCV fact sheets at TAG - Epclusa, HCV Genotypes, with updates on Viekira XR and Technivie

Feb 6
Genotype 1
Accepted manuscript online: 27 January 2017
Glecaprevir and Pibrentasvir for 12 Wks HCV Genotype 1 and Prior Direct-acting Antiviral Treatment
Media Coverage of this Article
Glecaprevir/pibrentasvir was highly effective and well tolerated for the treatment of hepatitis C virus genotype 1 infection in patients who previously failed treatment with direct-acting antivirals, according to the results of the phase 2 open-label MAGELLAN-1 study.

Genotype 3
Accepted author version posted online: 27 Jan 2017
Clinical characteristics, healthcare costs, and resource utilization in hepatitis C vary by genotype
These results suggest that liver disease progression varies by genotype and that CHC patients with GT3 appear to have more severe liver disease. These findings highlight the importance of effective HCV treatment for all patients and support guidelines for treatment of high-risk patients, including those with GT3.
Media Coverage of this Article

Feb 3
Full Text Article - Alimentary Pharmacology & Therapeutics.
All-oral direct-acting antiviral therapy in HCV-advanced liver disease is effective in real-world practice: observations through HCV-TARGET database
Media Coverage of this Article
DAA therapy effective in advanced liver disease in real-world study   
An all-oral, sofosbuvir-based therapy is a good option for hepatitis C virus (HCV) patients in genotype 1 or genotype 2 with advanced liver disease, according to a large observational, real-world study.... “Hepatitis C virus infection in those with advanced liver disease can be treated effectively with all-oral medications that are well tolerated and have high efficacy rate...  Successful treatment of HCV has led to a decrease in all-cause mortality and hepatocellular carcinoma, but it remains unknown whether this leads to improved liver function in those with advanced or decompensated liver disease.  

Feb 2
Genotype 1
Real-world Effectiveness for 12 Weeks of Ledipasvir-Sofosbuvir for Genotype 1 Hepatitis C
Does real-world experience with ledipasvir-sofosbuvir for genotype 1 HCV mirror the sustained viral response rates observed in clinical trials?

Good Results for Real-World Treatment of Hep C in Those With Advanced Liver Disease
However, people with genotype 3 of the virus and advanced liver disease have particularly poor treatment results.

Genotype 1-6

Full Text Articles - Genotype 1, 4, and 6
Journal of Viral Hepatitis
January 2017

Jan 30
Genotype 3
Week 4-response predicts sustained virologic response to all-oral direct-acting antiviral-based therapy in cirrhotic patients with hepatitis C virus genotype 3 infection

Jan 29
Genotype 1
Hepatitis C Treatment From “Response-guided” to “Resource-guided” therapy in the transition era from IFN-containing to IFN-free regimens
Accepted manuscript online: 26 January 2017

Jan 27
Genotype 3
New Genotype 3 Treatments - New HCV Treatments

Genotype 4
Full Text
Sofosbuvir in Combination with Simeprevir +/- Ribavirin in Genotype 4 Hepatitis C Patients with Advanced Fibrosis or Cirrhosis: A Real-World Experience from Belgium
Media Coverage of this Article
Combination Therapy Deemed Effective for Hepatitis C Genotype 4
Sofosbuvir and simeprevir, either with or without ribavirin, appears to be a safe and effective treatment for patients with hepatitis C genotype 4, according to a recent study.

Jan 26
Genotype 4
Hepatitis C Virus Genotype 4: Genotype 1's Little Brother
2017 Jan;24(1):4-12. doi: 10.1111/jvh.12620. Epub 2016 Dec 1.

Jan 24
Genotype 1-6
EMA grants accelerated assessment, validates marketing authorization application for AbbVie's HCV Regimen Glecaprevir/Pibrentasvir (G/P) for Major Genotypes (GT1-6)

Genotype 1 or 4
Treatment With Ledipasvir–Sofosbuvir for 12 or 24 Weeks in Kidney Transplant Recipients With Chronic Hepatitis C Virus Genotype 1 or 4 Infection

Genotype 1-6
What's Hot in Gastroenterology - New Drug Classes Seek to Further Improve Already Favorable Outcomes in Hepatitis C

Jan 20
Genotype 1-6
EMA validates Gilead's marketing authorization application for Sofosbuvir/Velpatasvir/Voxilaprevir
FOSTER CITY, Calif.--(BUSINESS WIRE)--Jan. 20, 2017-- Gilead Sciences, Inc. (Nasdaq: GILD) today announced that the company’s Marketing Authorization Application (MAA) for the investigational, once-daily, single tablet regimen of sofosbuvir 400 mg, velpatasvir 100 mg and voxilaprevir 100 mg (SOF/VEL/VOX) for the treatment of chronic hepatitis C virus (HCV)-infected patients has been fully validated and is now under assessment by the European Medicines Agency (EMA).

Genotype 3
Sovaldi-based regimens lead to high SVR rates in Egypt
Patients with hepatitis C virus infection in Egypt achieved rates of sustained virologic response at week 12 with Sovaldi-based regimens that were comparable to those demonstrated in phase 3 clinical trials, according to real-world study data.

HCV is one of the most significant health problems in Egypt, and accordingly, the country’s Ministry of Health National Treatment Programme “ensured that [Sovaldi; sofosbuvir, Gilead Sciences] became available in 2014 at prices appropriate for the scale of the epidemic of HCV and for the economic situation in Egypt,” investigators wrote. “Our aim was to assess the clinical effectiveness of the [sofosbuvir]-based treatment regimens,” — both dual and triple therapies — “and to demonstrate the predictors of response in our chronic HCV genotype 3 Egyptian patients.”

Jan 17
Genotype 3
Sofosbuvir with velpatasvir beat other HCV GT3 regimens
Researchers in the Netherlands found that Sovaldi plus velpatasvir, known as Epclusa in the United States, was the most effective regimen for the treatment of hepatitis C genotype 3 infection compared with other direct-acting antiviral regimens, according to published findings.

Jan 13
Genotype 3
Real-world use, effectiveness, safety of anti-viral treatment in chronic hepatitis C genotype 3
To validate the use, effectiveness and safety of anti-viral treatment in chronic hepatitis C genotype 3 infection under real-word conditions.

Genotype 1
Investigational HCV regimen highly effective in Japanese genotype-1 patients
Eight weeks of treatment with an investigational, ribavirin-free regimen of glecaprevir and pibrentasvir resulted in high rates of 12-week sustained virologic response…

Jan 11
Genotype 4
Full Text/Original Article Sofosbuvir-based treatment regimens: real life results of 14 409 chronic HCV genotype 4 patients in Egypt
To assess the clinical effectiveness and predictors of response to SOF-based treatment regimens, either dual therapy, with SOF/ribavirin (RBV) for 6 months or triple therapy with SOF/peg-IFN-alfa-2a/RBV for 3 months, in a cohort of patients treated in National Treatment Programme affiliated centres in Egypt.

Jan 9
Genotype 1
AbbVie's Regimen of Glecaprevir/Pibrentasvir (G/P) for HCV Achieved High SVR[12] Rates in Genotype 1
- 99 percent (n=105/106) of genotype 1 (GT1) chronic HCV-infected Japanese patients without cirrhosis achieved SVR[12] with 8 weeks of G/P

- Japan has one of the highest rates of hepatitis C infection in the industrialized world affecting approximately 1 million people, 60 to 70 percent of those GT1[1,2,3]

- Results demonstrated in CERTAIN-1 study are consistent with recently announced 8-week, GT1 data from the global registrational studies for G/P

Genotype 1,4, or 6
Healio - Zepatier highly effective for inducing SVR in HCV patients with prior treatment failure
Zepatier treatment for 12 weeks, with or without ribavirin, was highly effective for induction of sustained virologic response in patients infected with hepatitis C genotypes 1, 4 or 6, who failed prior peg-interferon and ribavirin treatments, according to the results of the C-EDGE Treatment Experienced trial. SVR12 was also achieved by patients with cirrhosis or a null response to previous treatment in this trial, and the treatment was generally well tolerated.

Genotype 1
Full Text
The effectiveness of daclatasvir based therapy in European patients with chronic hepatitis C and advanced liver disease
Received: 28 May 2016 Accepted: 10 December 2016 Published: 7 January 2017

Related Article
New Hope for Patients with Advanced Hepatitis C
Daclatasvir with sofosbuvir is an effective treatment for patients with hepatitis C who have a life expectancy of less than a year, according to a collaborative team of researchers.

Genotype 1
Short-term cost of interferon-free therapies for all HCV patients high yet cost-effective
A recent cost-effective analysis evaluating the value of interferon-free therapies for the treatment of hepatitis C virus infection genotype 1 revealed that administering less expensive regimens to non-cirrhotic patients and expensive yet more effective regimens to cirrhotic patients resulted in optimal outcomes for patients and insurers. Meanwhile, limiting treatment only to those with more advanced disease often resulted in poor outcomes, according to researchers.

Jan 8
Genotype 3
HCV: Fatty liver disease and genotype 3
In this post a collection of journal articles and videos reviewing HCV and fatty liver disease is offered; with a focus on individuals afflicted with both conditions. In addition given the development of steatosis (abnormal levels of fat in your liver) is higher in people with HCV and genotype 3, links are provided to current therapies in this difficult to cure genotype. Finishing off with several tips to help keep your liver healthy.

Jan 5
Genotype 1,3, and 4
Hepatitis C: efficacy and safety in real life
Key points
-Current real-world experience supports the use of either LDV/SOF±RBV or OBV/PTV/r±DSV±RBV in genotype 1 and 4 infected patients whatever the severity of fibrosis.
-HCV treatment history, HIV coinfection and previous liver or kidney transplantation do not influence the efficacy and safety of these two regimens.
-The efficacy of the SOF+SMV±RBV regimen was relatively low in real-world results.
-There is still not enough real-world data in patients infected with genotype 3 and other genotypes.

Jan 4
Genotype 1 or 2
All-Oral DAA Therapy in HCV-Advanced Liver Disease
In summary, all-oral, sofosbuvir-based HCV therapy in GT1 or GT2 patients with advanced liver disease presents a good option. Real-life data on SVR are encouraging and helps in improvement in severity of liver disease in most patients. It is unclear, based on short follow-up period, what the long-term benefits might be, and what baseline and on-treatment predictors might address potential benefit vs. harm. Long-term follow-up is needed to more convincingly address the benefits of eradicating HCV infection in those with advanced liver disease. While ledipasvir, an NS5A inhibitor and sofosbuvir combination has been the treatment of choice in GT1 patients, this combination is unfortunately not available in several countries. Ledipasvir and sofosbuvir have worked effectively in patients with decompensated liver disease.[16,26] However, in some countries such as Brazil with a large hepatitis C population, sofosbuvir and simeprevir are available while ledipasvir is not and thus sofosbuvir and simeprevir combination serves as an effective therapeutic option. Furthermore, with the wide spread use of the NS5A and sofosbuvir combination, there has been the emergence of NS5A resistance, thus making the protease inhibitor, simeprevir and sofosbuvir a viable rescue strategy. Also these data are relevant to regions of the World, where generic sofosbuvir is available and potentially simeprevir can be used in combination with success

Jan 3
Genotype 1
Cost-Effectiveness of Treating Hepatitis C with Sofosbuvir/Ledipasvir in Germany
Our aim was to assess the long-term cost-effectiveness of treating hepatitis C genotype 1 patients with sofosbuvir/ledipasvir (SOF/LDV) treatment in Germany

Jan 1
Genotype 1
Ledipasvir-Sofosbuvir Effective for Chronic HCV in Adolescents
Dec. 30, 2016 (HealthDay News) -- For adolescents with chronic hepatitis C virus (HCV) genotype 1 infection, ledipasvir-sofosbuvir is highly effective, according to a study published online Dec. 20 in Hepatology.

Genotype 4
Efficacy of Sofosbuvir Plus Simeprevir for HCV Genotype 4
Full Text Available

Genotype 1
Faldaprevir–Deleobuvir - Hepatitis C Virus Genotype-1b-Infected Patients w-Cirrhosis and Moderate Hepatic Impairment
In conclusion, in this small study in treatment-naïve and treatment-experienced patients with chronic HCV genotype-1b infection and mild or moderate hepatic impairment, the response to 24 weeks of treatment with faldaprevir, deleobuvir and ribavirin was not durable, with 74% of patients achieving SVR4 but only 57% achieving SVR12. Since this study was initiated, the HCV field has changed rapidly with the advent of new DAAs and all-oral DAA combinations. Because of this and based on the results of the phase 3 HCVerso1 and HCVerso2 trials [16], the development of the faldaprevir–deleobuvir combination has been terminated.

Of Interest
Nov 28, 2016
Breakdown of Hepatitis C Genotype Distribution Around the World
Some of the different hepatitis C genotypes are more prominent in certain areas than others, and researchers specified where they're found around the world in people who inject drugs.

Take a look back at the top HCV news stories of 2016. Sit back and review a collection of hepatitis C research articles, guideline updates, conference reports, learning activities, and news from around the web.

2016 Treating HCV according to genotype
News Archive

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