Progress in the hunt for hepatitis C cure

Updated: 2011-12-05 07:56By Liu Jie (China Daily)

Progress in the hunt for hepatitis C cure

BEIJING - William Lin, 36, said he felt gloomy when he was diagnosed with the hepatitis C virus (HCV) three years ago.

Ever since, the engineering manager of a multinational communications company has been taking interferon medication made by Swiss Roche Holding AG. "Actually, I don't like interferon, which needs to be injected. It is not convenient for me because I travel a lot. But I have no choice," said Lin.

He said he hopes a safe and convenient oral medication will soon be developed to replace the injected treatment.

Lin is among 40 million Chinese who suffer from HCV, one of the major causes of liver cirrhosis and the most common cause of liver cancer.

The situation is very serious in China, with Chinese patients accounting for about 25 percent of the 170 million global HCV infections, according to China's largest HCV survey released late last month.

Most Chinese HCV patients - 58.2 percent of those surveyed - are infected with genotype 1, a relatively difficult form of the disease to treat, said Wei Lai, director of the Peking University Hepatology Institute and vice-president of the Peking University People's Hospital, who coordinated the survey. He added that the Ministry of Health has listed HCV as one of the top 12 diseases that the government will increase efforts to prevent and treat in coming years.

Australia-based healthcare market research firm Decision Resources Inc estimated that sales of HCV therapies are expected to exceed $10 billion around the world in 2017, up from $2 billion in 2007. In China, the figure will reach $150 million next year, compared with $64 million in 2007.

The rise in HCV medication indicates huge market opportunities for related drugmakers, who are also striving to introduce oral medicine to complement interferon.

Bio-pharmaceutical company Bristol-Myers Squibb said it has developed a breakthrough in HCV treatment, creating oral direct-acting antiviral medications to complement interferon, a commonly used therapy now.

According to Douglas J. Manion, vice-president of the US-based company's development for neuroscience, virology and Japan, the oral medicines have the potential to be easier to take and safer than interferon. Interferon has to be injected, which increases the risk of blood infection, and it has adverse reactions, often resulting in poor patient compliance.

Multinational drugmaker Roche Holding AG introduced its interferon products in China as early as 2008 and claims it has around 80 percent of China's HCV treatment market.

Now the Swiss company is tapping the oral medicine sector by buying US-based Anadys Pharmaceuticals Inc for $230 million. By acquiring Anadys, Roche hopes to develop advanced all-oral treatment for HCV that does not use injectable interferon

Roche's archrival in the HCV sector, Schering-Plough Corp, is also a pioneer and has built its presence in China. The company was acquired by Merck & Co in 2009.

In addition, US-based Johnson & Johnson and Abbott Laboratories are both involved in the HCV business.

Chinese pharmaceutical enterprises are also striving to take market share. However, they are mainly focusing on generic drugs. Some domestic companies are trying to use traditional Chinese medicine to cure the infectious disease.

Lin said he hoped the medicine will be available in the Chinese market as soon as possible. Commercial appliance of the oral drug treatment is expected to take quite a while because clinical trials and approval from pharmaceutical authorities will be needed, insiders said.

As the majority of Chinese patients are suffering from difficult-to-treat HCV infections, drugmakers should develop some tailored medication in terms of physical conditions and gene characteristics for the nation with its 1.3 billion population and largest group of patients, according to Wei.

Manion from Bristol-Myers Squibb said that his company's newly developed oral direct-acting antiviral and polyethylene glycol-interferon alpha would be targeted at difficult-to-treat HCV infections, the type more than half of Chinese patients suffer from.

"Our research on a special group of patients, who have little or no response to interferon, finds that by combining our direct-acting antiviral with PEG-interferon alpha, the patients can be cured," said Manion. The company is expected to launch several new products for HCV within five years.

For HCV treatment, challenges still exist. Drug resistance has been a problem for scientists for years. Although there is no therapy that can treat patients in the long run without any resistance, gradual progress has been made. Companies had used "cocktail" medication - combining three to four medicines including interferon to offset resistance to each other. Now, the drugs can be reduced to two.

Increasing public awareness of the disease, with its long incubation period and the high incidence of liver cancer it causes, is also a problem. It needs to be solved by the government, academic institutions and businesses working together, both Wei and Manion said.

China Daily