HCV Genotype 1 No Longer a Treatment Bugbear

AGA Reading Room 02.16.2017

HCV Genotype 1 No Longer a Treatment Bugbear

by Pippa Wysong
Contributing Writer, MedPage Today

Hepatitis C (HCV) genotype 1 is now the HCV subtype most easily treated with direct-acting agents (DAAs), and cure rates approach 100%. Since genotype 1 infection is the most common subtype, affecting approximately 75% of HCV-infected patients worldwide, and was traditionally harder to treat, scientists directed efforts to develop DAAs effective against genotype 1. There are now multiple DAA regimens available for patients with genotype 1 HCV infection. Clinicians need to consider subtype (genotype 1a versus 1b), insurance factors, and patient factors such as the presence or absence of cirrhosis and the presence of resistant variants when deciding on which regimen to pick. In some situations, specific resistance testing should be done prior to initiating treatment in order to determine the efficacy of the chosen regimen.

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.

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