2018-HCV Genotypes/Treatment

New Page - 2019 HCV Genotype and Treatment

 ARCHIVES
2018 HCV Genotypes and 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. 

Archives 
Research Articles
Current full-text articles covering every aspect of hepatitis C.

The controversy over expensive new drugs for hepatitis C
Link to research and news articles addressing the high cost of hepatitis C drugs; insurance restrictions - private insurers/Medicaid - and availability of generic versions.

 HCV Guidance Updates
The American Association for the Study of Liver Diseases and the Infectious Diseases Society of America with the International Antiviral Society developed a living document with ever evolving guidelines to treat HCV

The following pages include guidance for management of  treatment-naive patients.
Genotype 1 
Genotype 2 
Genotype 3 
Genotype 4 
Genotype 5 or 6
The following pages include guidance for management of treatment-experienced patients.
Genotype 1 
Genotype 2 
Genotype 3 
Genotype 4 
Genotype 5 or 6 

Stay current with all guideline updates, "click here."
New Page - 2019 HCV Genotype and Treatment

Archives
December 2018
Dec 31, 2018

Dec 23, 2018
New HCV Clinical Advances 
Sit back and watch a live symposium from the November 2018 Liver Meeting featuring table discussions with leading physicians discussing viral hepatitis, launched by Chronic Liver Disease Foundation (CLDF) on December 13, 2018.

Real-World HCV Study Finds Sofosbuvir/Ledipasvir Safe, Effective

Late Relapse of HCV After Daclatasvir and Asunaprevir Therapy
Is SVR achieved with all oral DAA therapy as long-lasting as that achieved with interferon-based therapy?

Hepatitis C - Barriers To Eradication
Despite all of the advances in hepatitis C treatment, it remains a “silent epidemic” with more than 70 million people infected worldwide. In this months issue of HCV Next, Michael S. Saag, MD., writes about HCV eradication and the huge barriers still in place.

Dec 22. 2018
Glecaprevir/Pibrentasvir Is Safe, Effective in Treatment of HCV in Real-World Setting

Real-world effectiveness and safety of Harvoni with/without ribavirin hepatitis C virus genotype 1

Dec 17, 2018
Great news for New Zealanders pangenotypic regimen Maviret unrestricted access from Feb 2019 with $0 co-payment - PHARMAC funding decision gives Kiwis with hepatitis C access to a potential cure

Dec 12, 2018
The team enrolled 22 HCV patients with compensated liver disease and genotypes 1 to 6, who were either treatment naive or interferon experienced. Participants were treated with one of four DAA regimens chosen by the investigators.

Review Article
Treatment of hepatitis C virus genotype 4 in the DAA era 
In this review, we discuss the efficacy of DAA therapy in GT4 HCV infection with specific reference to more recent studies, including those conducted in a ‘field-practice’ scenario. Overall, DAA-based regimens appear more effective also in the poorly-explored setting of patients with HCV GT4 infection. Despite an overall limited number of patients was evaluated, favorable results are being derived from studies on ombitasvir/paritaprevir/ritonavir, sofosbuvir and velpatasvir, whether or not in association with voxilaprevir, and with the new combined therapy glecaprevir + pibentasvir.

Mavyret
8 weeks of Maviret cures 98% of people with hepatitis C and cirrhosis
Keith Alcorn / 14 November 2018
An 8-week course of the combination of glecaprevir and pibrentasvir (Maviret) is highly effective in curing hepatitis C in people with compensated cirrhosis, across a wide range of genotypes, Robert S. Brown of Weill Cornell Medical College reported at the AASLD Liver Meeting in San Francisco this week.

High SVR12 rate for 16 week glecaprevir/pibrentasvir regimen in HCV GT1

In conclusion, treatment with the all‐oral IFN‐free adult formulation of OBV/PTV/r±DSV±RBV for 12 or 24 weeks was well tolerated and highly efficacious in adolescent patients 12‐17 years of age who are infected with HCV GT1 or GT4.

Nov 8, 2018
Alimentary Pharmacology & Therapeutics, November 8, 2018

Nov 3, 2018
Full-Text
Minireview - Era of direct acting anti-viral agents for the treatment of hepatitis C 
The different DAAs with their dose, efficacy, side effects, drug-drug interactions as well as specific treatment against different genotypes of HCV will be discussed.

Nov 2, 2018
Full-Text
New highly diverse hepatitis C strains detected in sub‐Saharan Africa have unknown susceptibility to direct‐acting antiviral treatments 

TGIF - Hepatitis Weekly Review & November Newsletters

Nov 1, 2018
Glecaprevir/pibrentasvir achieved high SVR12 rates, comparable with data reported in registrational studies, and was well tolerated in patients with HCV genotype 5 or 6 infection with compensated liver disease.

Abstract
Safety and efficacy of sofosbuvir-based direct-acting antiviral regimens for hepatitis C virus genotype 6 in southwest China: real-world experience of a retrospective study.
In conclusion, SOF plus DCV and SOF plus VEL were safe and achieved a high SVR12 rate for treatment-naïve patients with HCV GT6 without liver cirrhosis. 
Wu DB, et al. J Viral Hepat. 2018

October 2018
Oct 19, 2018
Ledipasvir/Sofosbuvir Effective for Relapsing Hepatitis C Virus GT1
For patients with hepatitis C genotype 1 (HCV GT1) who experience virologic relapse after an antiviral regimen of simeprevir (SMV) and sofosbuvir (SOF), a regimen of ledipasvir/sofosbuvir (LDV/SOF) with or without ribavirin (RBV) is effective and well tolerated, according to results published in the Annals of Hepatology.

Abstract
Sustained Viral Response in Genotype 4 Chronic Hepatitis C Virus–infected Children and Adolescents Treated With Sofosbuvir/Ledipasvir

Oct 17, 2018
Liver injury can occur during antiviral therapies with direct-acting antivirals (DAAs), potentially necessitating discontinuation of the therapies, with consequent worsening of the sustained viral response (SVR) rates, in patients with hepatitis C virus (HCV). To clarify the mechanisms involved in serum transaminase level elevation, we performed a retrospective evaluation of the serum concentrations of daclatasvir and asunaprevir, both classified as DAAs, in patients receiving treatment with a combination of the two drugs. 

Oct 10, 2018
Hepatitis C - Vosevi safe, effective in ‘triple-infected’ patients with HCV, HBV, HIV
PHILADELPHIA – The direct-acting antiviral Vosevi demonstrated an average sustained virologic response rate of 87% among patients who were “triple-infected” with hepatitis C genotype 3, hepatitis B and HIV, as presented at the American College of Gastroenterology Annual Meeting.

Oct 2, 2018
October Newsletters - Should Liver Disease Patients Get Screened For Liver Cancer?

Genetics of HCV-GT4-infected Patients Treated With OBV/PTV/r
What are the most prevalent GT4 subtypes among GT4-infected patients treated with OBV/PTV/r with or without RBV? This study aimed to identify subtypes by geographic region and country.
Journal of Viral Hepatitis

Oct 1, 2018
New Review Highlights Efficacy of Elbasvir/Grazoprevir for Hepatitis C
A new review of clinical trial data show the combination therapy elbasvir/grazoprevir (EBR/GR) has high rates of efficacy for patients with genotypes 1a, 1b, and 4 chronic hepatitis C (HCV) infection.

Novel ‘genotype 8’ surfaces among four patients with HCV
Borgia SM, et al. J Infect Dis. 2018;doi:10.1093/infdis/jiy401.
HCV Next, September/October 2018

September 2018
Sept 25, 2018


Sept 14, 2018
Hepatitis C; Does the old-fashioned sofosbuvir plus ribavirin treatment in genotype 2 still works for Koreans?

Sept 11, 2018
Hepatitis C virus genotype 3: clinical features, current and emerging viral inhibitors, future challenges
HCV represents a global health threat. Specifically, genotype 3 is known to have a rapid disease progression relative to other genotypes, leading to advanced stages of liver disease far earlier. Through the manipulation of lipid metabolic pathways, steatosis impairs the treatment response. However, even in patients with advanced liver disease, new DAA regimens are slowly turning the tide against genotype 3. A high SVR can be achieved in patients with a spectrum of liver disease, as well as those coinfected with HIV. New DAA regimens are also better tolerated by patients, since they have fewer adverse side-effects. We believe that with this expanded armamentarium, genotype 3 should no longer be considered difficult to treat.

Hepatitis C patients wait for Maviret’s arrival
Korean physicians and patients have expressed high expectations for AbbVie Korea’s Maviret (ingredient: glecaprevir/pibrentasvir), a chronic hepatitis C therapy that reduced the treatment time by one month, the company said.

Sept 10, 2018
Welcome, check out the latest news, review this months collection of newsletters, and finish off by reading a handful of well written blogs focused on living well with hep B or C.

Vosevi Beats Hepatitis C Regardless of Drug Resistance 
In a recent study of people whose previous hep C regimen failed to cure their infection, Vosevi cured almost all of them.

OBV/PTV/r +/- DSV in HCV GT4-infected Patients With Severe CKD
Liver International, September 7, 2018

HCV Viral Subtypes and SVR Rates in Trials of DAA Regimens
 Journal of Viral Hepatitis, September 4, 2018

 August 2018
Aug 30, 2018

Hepatic decompensation during paritaprevir/ritonavir/ombitasvir/dasabuvir treatment for genotype 1b chronic hepatitis C patients with advanced fibrosis and compensated cirrhosis.

Our study suggests that these patients should be identified and receive a triple DAA combination regimen as first-line treatment.

Aug 22, 2018
In case you missed it
Systematic review and meta-analysis: real-world effectiveness of direct-acting antiviral therapies in chronic hepatitis C genotype 3 in Asia

Aug 9, 2018
FDA: Hepatitis C Drug Labeling Updated to Include New Clinical Data
The FDA has approved updates to the labeling for hepatitis C virus (HCV) drug glecaprevir and pibrentasvir (Mavyret) to include new data from 2 clinical studies, according to a press release

Aug 6, 2018
Hep C and B August Newsletters - Liver Wellness Tips & Generic Direct Acting Antivirals

Aug 5, 2018
Hepatitis C-Diabetes associated w-advanced fibrosis and progression in HCV non-genotype 3 patients

 July 2018
July 17, 2018
Novel ‘genotype 8’ surfaces among four patients with HCV
The study comprised four patients with HCV who were originally diagnosed with genotype 5 by commercial assays. The patients resided in Canada and were originally from Punjab, India. “The discovery of a novel HCV GT8 confirms the endemic nature of HCV in the Indian subcontinent, particularly in the Punjab State, which has one of the highest prevalence rates in the country and has important implications for the genetic and epidemiological characterization of the HCV epidemic worldwide,” Borgia and colleagues wrote. Based on maximum likelihood phylogenetic analysis, the researchers concluded that the patients were infected with a novel, distinct HCV genotype referred to as “genotype 8.” Compared with previously identified HCV genotypes, genotype 8 had an average 67% to 71% similar sequence identity across the NS3, NS5A and NS5B genes.
Read more.…..

Full Text @ Medscape:
Efficacy of Generic Oral DAAs in Patients With HCV Infection
Journal of Viral Hepatitis, July 20, 2018 

July 12, 2018
Full-Text Article
Treatment of chronic hepatitis C virus (HCV) infection has been revolutionized with the development of direct-acting antiviral agents (DAAs). Eight to twelve weeks of all-oral, once-daily treatments is now the standard of care and viral eradication can be achieved in >95% across different patient populations. Despite these advances, several unresolved issues remain, including treatment of HCV genotype 3, chronic kidney disease, and in patients in whom DAA therapy has failed. Glecaprevir/pibrentasvir (GLE/PIB) and sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) are the most recently approved DAA regimens. Given the overwhelming success of modern DAA-based therapies, GLE/PIB and SOF/VEL/VOX are also likely to represent the last DAAs to be approved. Both are pangenotypic, once-daily, all-oral DAA combinations that have the potential to close the gaps in the current DAA treatment portfolio. Here, we review the challenges associated with current DAAs and how these two regimens may be implemented in existing treatment algorithms.

Merck’s Zepatier (grazoprevir/elbasvir) plus Gilead Sciences’ Sovaldi (sofosbuvir), with or without ribavirin, cured genotype 3 of hepatitis C virus (HCV) at high rates in a recent trial.
July 9, 2018 • By Benjamin Ryan
Publishing their findings in the journal Hepatology, researchers conducted a Phase II randomized open-label study, known as C-ISLE, of Zepatier plus Sovaldi with or without ribavirin among those with genotype 3 of HCV and compensated cirrhosis (the milder form of the severe liver disease).
Those who had not been treated for hep C before were given Zepatier plus Sovaldi and ribavirin for eight weeks or Zepatier plus Sovaldi for 12 weeks. Those who had been previously treated with interferon and ribavirin received Zepatier plus Sovaldi with or without ribavirin for 12 weeks or Zepatier plus Sovaldi for 16 weeks.
Ninety-one percent (21 of 23) of the first-timers to treatment who were treated for eight weeks achieved a sustained virologic response 12 weeks after completing therapy (SVR12, considered a cure), as did 96 percent (23 of 24) of those treated for 12 weeks. Among those who had been treated before, 94 percent (17 of 18) and 100 percent (17 of 17) of those treated for 12 and 16 weeks, respectively, were cured.
Read more…https://www.hepmag.com/article/zepatier-plus-sovaldi-beats-hep-c-cirrhosis-genotype-3

Options for hepatitis C treatment (SOF/VEL or GLE/PIB), both well-tolerated, highly effective and treats all genotypes.

June 2018
June 29, 2018
Effectiveness of Ledipasvir/Sofosbuvir and Predictors of Treatment Failure in Members with Hepatitis C Genotype 1 Infection: A Retrospective Cohort Study in a Medicaid Population

June 23, 2018
Does the presence of resistance-associated substitutions impact the efficacy of therapy with sofosbuvir/velpatasvir with or without ribavirin in patients with HCV genotype 3?

Epclusa yields high SVR in HCV genotype 3 with compensated cirrhosis

Efficacy and Safety of Sofosbuvir-containing Regimens in Chronic Hepatitis C Patients with Genotype 2 and 3: a Comprehensive Analysis of 18 Randomized Controlled Trials
We searched randomized controlled trials (RCTs) which analyzed the efficacy and safety of sofosbuvir-containing regimens for HCV GT 2/3 infected patients and collected data. The endpoints were sustained virological response 12- and 24-weeks after the cessation of therapy (SVR12 and SVR24), the adverse events (AEs) and the severe adverse events (SAEs).

June 14, 2018
SVR 24 Two Weeks After a Tripled Dose of Daclatasvir in an HCV Genotype 3 Patient (Case Report)

June 12, 2018
High SVR12 with 8-week and 12-week glecaprevir/pibrentasvir therapy: An integrated analysis of HCV genotype 1–6 patients without cirrhosis

Sofosbuvir-velpatasvir-voxilaprevir effective in previously treated chronic hepatitis C

June 7, 2018
Of Interest:
Despite the availability of new DAA regimens and changes in restrictions of these therapies, absolute denials of DAA regimens by insurers have remained high and increased over time, regardless of insurance type.

June 5, 2018
Cost‐effectiveness of generic sofosbuvir/velpatasvir versus genotype‐dependent direct‐acting antivirals for hepatitis C treatment


June 1, 2018
Those on Daklinza-Based Hep C Regimens Do Well
Few people saw their liver disease progress, and there were scant numbers of relapses more than 12 weeks posttreatment in a large study.

May 25, 2018
In this learning activity the good doctor will discuss screening strategies, stigma, patient-related barriers to treatment, hepatitis C testing for identifying current infection, and tests used to stage fibrosis. Also discussed is treatment for HCV patients with cirrhosis, as well as treatment adherence, duration, treatment according to HCV genotype, ending with "How Much Care Do The Cured Need?" 

May 24, 2018
Hepatitis C Virus Infection Treatments to Be Discontinued:Technivie, Viekira XR and Simeprevir

May 17, 2018
All Genotypes

May 14, 2018
Efficacy and Safety of 12 Weeks of Elbasvir +/- Grazoprevir +/- Ribavirin in Participants With Hepatitis C Virus Genotype 2, 4, 5 or 6 Infection
Patients with non-genotype 1 HCV infection differ with regard to response to DAAs. This study evaluated the efficacy and safety of EBR/GZR, with or without RBV, in HCV genotype 2, 4, 5, or 6 infection.

May 11, 2018
The results point to the effectiveness of second-generation DAAs in HCV Brazilian patients, especially those with genotype 1. Furthermore, that patients with genotype 3 need more attention and adjustments in available treatment options... Besides the high response rates, some points must be noted. GT 3 appears to be the most difficult to treat and is the second most common genotype in Brazil (after genotype 1). However, only two treatment options are available in the country to date: sofosbuvir with daclatasvir and sofosbuvir with peginterferon alfa plus ribavirin. Previous observational studies have also shown a lower SVR rate for GT 3 patients.17; 20; 21 ; 22 Other international guidelines, such as those of the European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD) recommend other treatment options for GT 3,7 ; 8 such as sofosbuvir with velpatasvir, or elbasvir with grazoprevir. It is also important to mention that many of these patients received treatment of sofosbuvir with daclatasvir for a short duration (12 weeks), which may have influenced the SVR rate in these cases. Recently, the Brazilian government has approved the extension of the sofosbuvir with daclatasvir treatment to 24 weeks for cirrhotic patients.4 This, together with the addition of other drugs could increase the likelihood of cure for patients with GT 3.

May 9, 2018
April 27, 2018
Harvoni effective for HCV genotype 4, including cirrhotic cases

Zepatier safe, effective in black patients with HCV, comorbidities
Zepatier was effective and well-tolerated in black patients with hepatitis C genotype 1 and 4 compared with overall reported safety profile, according to recently published data.

April 26, 2018
Pilot study
Safety and efficacy of sofosbuvir plus ledipasvir in children 6‐ to 12‐ year old with chronic HCV genotype 4 infection.

Liver Congress 2018 Slides @ NATAP
Time to Viral Suppression Does not Impact SVR in Patients Treated With Glecaprevir/Pibrentasvir for 8 Weeks

April 21, 2018
LINK - Clinical Care Options CCO - Review Capsules Summaries, download slides, and listen to audio commentary from expert-led Webinars covering critical studies on viral hepatitis.
High SVR12 Rate With 8 Weeks of Sofosbuvir/Velpatasvir in Real-World Retrospective Analysis of Treatment-Naive Patients With Genotype 3 HCV and Fibrosis
Main Findings
In ITT population, 93% (84/90) of noncirrhotic, treatment-naive patients with genotype 3 HCV infection achieved SVR12 following 8 weeks of sofosbuvir/velpatasvir
Lost to follow-up: n = 2
Premature discontinuation: n = 2
Death: n = 1
Reinfection without subsequent spontaneous clearance: n = 1
In mITT population, 100% of patients achieved SVR12
High rates of SVR12 observed across selected subgroups
Subgroup, n/N (%)
SVR
ITT Population
mITT Population
F3 fibrosis
23/28 (82.1)
23/23 (100)*†‡§
HCV RNA > 6,000,000 IU/mL
5/6 (83.3)
5/5 (100)†
HIV coinfected
2/3 (66.6)
2/2 (100)†
Quantifiable HCV RNA at end of treatment
7/7 (100)
7/7 (100)
Daily supervised methadone
35/38 (92.1)
35/35 (100)†‡║
IVDU
8/8 (100)
8/8 (100)
Non-IVDU
14/15 (93.3)
14/14 (100)‡
Positive screen for drugs of abuse
4/4 (100)
4/4 (100)

Addition of RBV Associated With Increased Efficacy of 12 Weeks Sofosbuvir/Velpatasvir in Patients With Genotype 3 HCV Infection and Compensated Cirrhosis
Summary of Key Conclusions
In NS5A-naive patients with genotype 3 HCV infection and compensated cirrhosis, sustained virologic response at 12 weeks posttreatment (SVR12) rate numerically higher in those receiving sofosbuvir (SOF)/velpatasvir (VEL) with ribavirin (RBV) vs SOF/VEL alone
SVR12 rate 96% vs 91%, respectively
Fewer relapses observed with use of RBV
In both treatment arms, NS5A resistance associated substitutions (RAS) at baseline associated with reduced SVR12 rate, particularly Y93H
Treatment well tolerated
Few grade 3/4 adverse events (AEs), serious AEs, discontinuations for AEs in both treatment arms
Use of RBV associated with increased toxicities

MAGELLAN-3 Interim Analysis: High SVR12 Rate Achieved With GLE/PIB Plus SOF and RBV in HCV-Infected Patients With HCV Infection With Previous GLE/PIB Failure 
Overall SVR12 rate of 96% with no study drug–related serious adverse events at interim analysis.

April 20, 2018
In Case You Missed It
In summary, ledipasvir/sofosbuvir for 8 weeks was a highly effective treatment option for treatment-naive HCV genotype 4 patients without cirrhosis. Cirrhosis status did not affect the high SVR rates observed with ledipasvir/sofosbuvir for 12 weeks in interferon-experienced patients, and ledipasvir/sofosbuvir+ribavirin for 12 weeks was highly effective in patients previously treated with sofosbuvir+ribavirin or ledipasvir/sofosbuvir±ribavirin. The addition of ribavirin to the treatment regimen did not provide benefit in terms of overall SVR12 rates but did increase the incidence of adverse events.

Of Interest - Case Report
A case report of sofosbuvir and daclatasvir to treat a patient with acute hepatitis C virus genotype 2 monoinfection
We report a young female with acute HCV genotype 2 monoinfection who was successfully treated with sofosbuvir (SOF) and daclatasvir (DCV) and had achieved SVR 36 weeks after the end of treatment. The presented case reveals that patients with AHC are less prone to obtain spontaneous clearance. Early DAAs treatment can be provided to help patients avoid chronic liver disease caused by HCV infection. This case supports the hypothesis that patients with acute HCV genotype 2 monoinfection would benefit from antiviral treatment with sofosbuvir and daclatasvir. We look forward to large-scale clinical studies that will confirm the effectiveness of DAAs in treating AHC. Now might be the time to revisit the treatment guidelines for patients with AHC.

April 16, 2018
DAA therapy effective in patients with HCV and advanced cirrhosis - Real World Experience from the HCV-TARGET Cohort
The researchers enrolled 488 patients in the safety cohort and 412 patients in the efficacy cohort; of those, 373 achieved SVR12 and 39 failed treatment. Patients received a variety of approved regimens.

April 15, 2018
Long term follow up of HCV pts with F2-F3 fibrosis who had achieved SVR with DAA therapy
Liver-related & HCC events were rare after up to 144 weeks of follow-up in patients with F2-F3 fibrosis who had achieved SVR with DAA therapy: Results from the Gilead Sciences SVR Registry

April 14, 2018
International Liver Congress 2018: 8-weeks of Zepatier (elbasvir/grazoprevir) may effectively treat HCV genotype 4
In patients with hepatitis C virus genotype 4, 8 weeks of Zepatier showed effective treatment of the virus, according to a presentation at the International Liver Congress 2018.

April 13. 2018
Eight weeks of treatment with Epclusa cured almost all people receiving opioid substitution therapy
An eight-week course of sofosbuvir/velpatasvir (Epclusa) cured almost all people with hepatitis C genotype 3 without cirrhosis receiving treatment alongside opioid substitution therapy through community pharmacies or prisons in the Greater Glasgow area, Alison Boyle of Gartnavel Hospital, Glasgow, reported at the 2018 International Liver Congress in Paris on Thursday. Genotype 3 is especially common in people who inject drugs and former drug users. It has been considered 'harder to cure' although recent studies of newer agents in people with genotype 3 have shown high cure rates.

First real-world data on Mavyret showing safety & effectiveness in HCV Genotype 1-6
Shared on Twitter today by @HenryEChang - First real-world data from the Deutsches Hepatitis C-Register (DHC-R) showing favorable safety & excellent effectiveness of G/P in HCV GT1-6 patients with 97% SVR12 & no virologic failures to date.

April 12, 2018
Liver Congress™ 2018 First real-world studies report glecaprevir/pibrentasvir to be effective and well tolerated in chronic HCV infection 
The results of the first real-world studies assessing the effectiveness and safety of glecaprevir/pibrentasvir (G/P) in patients with chronic hepatitis C virus (HCV) infection have confirmed high rates of viral suppression and a favourable safety profile in patients receiving 8-16 weeks of treatment.

Liver Congress™ 2018 Affordable hepatitis C combination treatment - Target price of US$300 for a 12-week treatment
New affordable hepatitis C combination treatment shows 97% cure rate
An affordable hepatitis C combination treatment including the new drug candidate ravidasvir has been shown to be safe and effective, with extremely high cure rates for patients, including hard-to-treat cases, according to interim results from the Phase II/III STORM-C-1 trial presented by the non-profit research and development organisation Drugs for Neglected Diseases initiative (DNDi) at the International Liver Conference in Paris.

View all Liver Congress updates, here.....

April 10, 2018
Blog Updates: Pill testing as harm reduction, Vitamin B12 and Your Liver & International Liver Congress

Full-Text


April 6, 2018
Full-Text
Prevalence and genotype distribution of hepatitis C virus infection among patients with type 2 diabetes mellitus.

April 4, 2018
Full-Text
March 29, 2018
Authors investigated the efficacy and safety of sofosbuvir/velpatasvir (SOF/VEL) ± ribavirin (RBV), as well as the consequence of nonstructural protein 5A (NS5A) resistance-associated substitutions (RASs) and RBV use on the treatment outcome in hepatitis C virus (HCV) genotype 3 (GT3) infection in patients from 10 treatment centres across Germany. Findings demonstrated the safety and high efficacy of 12 weeks of SOL/VEL ± RBV in HCV GT3 across a diverse patient cohort. The presence of baseline NS5A RASs was a rare occurrence and it did not influence SVR, irrespective of the use of RBV.

March 27, 2018
Daclatasvir plus asunaprevir in treatment-naïve patients with hepatitis C virus genotype 1b infection
This phase 3, placebo-controlled study assessed the efficacy and safety of daclatasvir (NS5A inhibitor) plus asunaprevir (NS3/4A protease inhibitor) in treatment-naïve patients from mainland China, Russia and South Korea with hepatitis C virus (HCV) genotype 1b infection. The rate of sustained virologic response at posttreatment week 12 among patients in the immediate treatment arm was 92%, which was significantly higher than the historical comparator rate (70%). The combination was well tolerated during 24 wk of treatment. These results demonstrate that for countries such as China, where interferon-based combinations are still widely used for the treatment of HCV genotype 1b, daclatasvir/asunaprevir offers a more efficacious and tolerable alternative with a shorter treatment duration.

March 21, 2018
Quadruple combination therapy using daclatasvir, asunaprevir, pegylated interferon, and ribavirin led to high rates of sustained virologic response (SVR) in treatment-experienced patients with hepatitis C virus genotype 4 (HCV GT4), according to a study published in the European Journal of Gastroenterology & Hepatology.

March 16, 2018
A newly discovered hepatitis C virus (HCV) genotype 1 subtype harbors multiple resistance-associated mutations that combine to block therapeutic effect of NS5A inhibitor direct-acting antivirals (DAAs).

March 15, 2018
Recently published data showed that treatment outcomes did not differ between 8 weeks and 12 weeks of Harvoni among black patients with hepatitis C, contrary to guideline recommendations.

March 13, 2018
Chronic hepatitis C medication now available for all British Columbians
ANY British Columbian living with chronic hepatitis C now is able to access treatment, regardless of the severity of their disease, Health Minister Adrian Dix announced on Tuesday
The following chronic hepatitis C medications are covered under PharmaCare:
Daklinza (daclatasvir)
Epclusa (sofosbuvir/velpatasvir)
Harvoni (ledipasvir/sofosbuvir)
Sovaldi (sofosbuvir)
Vosevi (sofosbuvir/velpatasvir/voxilaprevir) – new
Zepatier (elbasvir/grazoprevir)

 March 12, 2018
Genotype 1b
In The Media, more on;
Elbasvir, grazoprevir combination successfully treats Hepatitis C genotype 1b

Of Interest
March 2018 - Recruiting hepatitis C clinical trials

March 10, 2018
Patient To Patient Video - Treating HCV according to genotype with a focus on HCV genotype 3
Watch - a look at current therapies used to treat the hepatitis C virus across all HCV genotypes

Of Interest
Article in Alimentary Pharmacology & Therapeutics · March 2018
Full Text: The adverse effects of interferon-free regimens in 149 816 chronic hepatitis C treated Egyptian patients
Full Text article downloaded and shared by @HenryEChang  via Twitter.

March 8, 2018
Genotype 1 & 4
Zepatier effective in MSM with acute HCV genotypes 1, 4
Efficacy among HIV-positive men who have sex with men infected with acute hepatitis C, according to study results presented at the Conference on Retroviruses and Opportunistic Infections, also known as CROI.“In the Netherlands, the group with ..

March 5, 2018
March HCV Newsletters & America’s Opioid Crisis: Overdoses Still Increasing

SVR similar with, without ribavirin after Harvoni treatment for HCV
The addition of ribavirin to 12 weeks of Harvoni showed little therapeutic benefit in patients undergoing retreatment for hepatitis C after failing to achieve sustained virologic response with a prior NS5A inhibitor-containing regimen, according to recently published data.

Genotype 2 or 3
Efficacy and Safety Results of Patients With HCV Genotype 2 or 3 Infection Treated With Ombitasvir/paritaprevir/ritonavir and Sofosbuvir With or Without Ribavirin (QUARTZ II-III)
This study investigated the efficacy and safety of 12-week OBV/PTV/r + SOF with or without RBV in patients with HCV genotype 2 or 3 infection, including those with cirrhosis.

Minireview - DAAs and the occurrence or recurrence of HCC among patients with HCV related liver disease
Genotype based variation of HCC in DAA treated patients
HCV genotype is an important consideration when considering progression to HCC. HCV genotype 3 is generally...

February 2018
Feb 28,2018
Journal, and patient blog updates - Beyond one virus: vaccination against hepatitis B after hepatitis C treatment.
Zepatier effective for HCV genotype 3 regardless of experience, resistance
Managing the Fruits of HCV Cure: How Much Care do the Cured Need?
Journey to the Cure: What is the Future of the Hep B Cure?
Hep C Patient John Conquers Hepatitis C, Cirrhosis, Liver Cancer, and Liver Transplant

Feb 28, 2018
Ontario Expands Patient Access to Chronic Hepatitis C Therapies On Public Drug Plan
Gilead Sciences Canada, Inc. (Gilead Canada) today recognizes the Ontario Ministry of Health and Long-Term Care for its leadership in the expansion of access to therapies that treat chronic hepatitis C virus infection under the Ontario Drug Benefit (ODB) Program. Today, all eligible ODB recipients will have greater access to treatment, regardless of the severity of disease (fibrosis level), to achieve a cure and improve their quality of life. Patients with chronic hepatitis C will no longer have to wait for their disease to progress before starting treatment.

Feb 21, 2018
All Genotypes
Gilead’s pan-genotypic treatment for hepatitis C Vosevi has won the National Institute for Health and Care Excellence’s seal of approval for use on the NHS.
Gilead’s pan-genotypic treatment for hepatitis C Vosevi has won the National Institute for Health and Care Excellence’s seal of approval for use on the NHS

Inductive Effect of a Ritonavir-Containing Hepatitis C Treatment Regimen on Warfarin in a Patient-A Case Report.
Rosene AC, et al. J Pharm Pract. 2018.
The warfarin management strategy for a mechanical mitral valve patient initiated on a ritonavir-based hepatitis C treatment regimen is described. A 62-year-old male with a past medical history of hepatitis C genotype 1a and stable warfarin dose history was initiated on a concomitant Viekira Pak® VP) regimen containing ritonavir.

Feb 18, 2018
Genotype 1
Although recently approved glecaprevir-pibrentasvir and sofosbuvir-velpatasvir-voxilaprevir with pangenotypic activity and a high barrier to resistance may be used increasingly and may also fill an important role as pangenotypic regimens for patients who previously failed DAA therapy, up to 5–10% of treated patients still fail some of the current recommended first-line DAA regimens, which leads to the selection of resistant variants, making regimen selection a major consideration for providers and patients.

Genotype 1 or 4
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Abstract
Genotype 4

Of Interest
Feb 12, 2018
Liver International Special Issue: Treatment of HCV with direct-acting antiviral agents: 100% cure?
In this paper, we will review the available data on recently approved direct-acting antiviral agents, with sustained virological response that reaches almost 100%.
daclatasvir; DSV, dasabuvir; EBV, elbasvir; GLE, glecaprevir; GRZ, grazoprevir; LDV, ledipasvir; OMV, ombitasvir; PIB, pibrentasvir; PTV, paritaprevir; RTV, ritonavir; SMV, simeprevir; SOF, sofosbuvir; VEL, velpatasvir

Feb 9, 2018
Genotype 1, 2, 3 or 4
We analysed data from patients with HCV infection and liver cirrhosis to evaluate predictors of functional benefit for identifying patients profiting most from antiviral therapy beyond HCV eradication.

Feb 6, 2018
AbbVie receives a positive recommendation from the CADTH Canadian Drug Expert Committee for MAVIRET™
MONTREAL, Feb. 6, 2018 /CNW/ - AbbVie (NYSE: ABBV), a global, research and development-based biopharmaceutical company, announced that the CADTH Canadian Drug Expert Committee (CDEC) issued a positive recommendation for MAVIRET™ (glecaprevir/pibrentasvir tablets), a once-daily, ribavirin-free treatment for adults with chronic hepatitis C virus (HCV) infection across all major genotypes (GT1-6)2. MAVIRET is the only 8-week, pan-genotypic treatment for patients without cirrhosis and who are new to treatment,* who make up a large portion of HCV patients in Canada.

January 2018
Jan 30, 2018

Jan 28, 2018
Genotype 1-6
Read notable research articles and blog updates on the topic of viral hepatitis, including a new learning activity at Medscape; Treating Genotype 1-6 - HCV Treatment: Incorporating Glecaprevir/Pibrentasvir and sofosbuvir/Velpatasvir/Voxilaprevir Into Clinical Practice.

Genotype 1 and 2
Efficacy of direct-acting antiviral treatment for chronic hepatitis C: A single hospital experience
Direct-acting antivirals have been approved for the treatment of hepatitis C virus (HCV) genotype 1 and 2 infections in Japan since 2011. In the new era of DAA therapy, predictors who fail to respond to DAA might be compromised by resistance-associated substitutions. There have been few reports of daclatasvir/asunaprevir failure because daclatasvir/asunaprevir is limited in Japan. Therefore, it might be important to report these cases for future research and treatment of HCV.

Jan 25, 2018
Full Text

Jan 23, 2018
This review is a collaboration between primary care and hepatology providers to explore all aspects of HCV management: acute versus chronic HCV infection, transmission and testing, and diagnosis and treatment. Specific medications for the treatment of HCV infection are considered, and patient and medication factors including genotype, liver disease status, and comorbidities affecting medication choice are discussed.

Chronic kidney disease stage G3 correlates with lower SVR rate
Genotype 2
Sovaldi with ribavirin was safe and effective among a cohort of Japanese patients with hepatitis C genotype 2. However, Chronic Kidney Disease, especially stage G3, correlated significantly with a lower rate of SVR.

In case you missed it
The Effect of Shorter Treatment Regimens for Hepatitis C on Population Health and Under Fixed Budgets.
Direct acting antiviral hepatitis C virus (HCV) therapies are highly effective but costly. Wider adoption of an 8-week ledipasvir/sofosbuvir treatment regimen could result in significant savings, but may be less efficacious compared with a 12-week regimen. We evaluated outcomes under a constrained budget and cost-effectiveness of 8 vs 12 weeks of therapy in treatment-naïve, noncirrhotic, genotype 1 HCV-infected black and nonblack individuals and considered scenarios of IL28B and NS5A resistance testing to determine treatment duration in sensitivity analyses.

New Issue @ Healio
HCV Next - ‘Think Outside the Box’ to Finance HCV Elimination
New Pricing Marks Potential HCV Treatment Landscape Revolution

Jan 18
Editorial: direct-acting antivirals significantly improve quality of life in patients with HCV

Jan 11
Genotype 1, 4 & 3
How will data presented at AASLD 2017 on 8-week therapy have an impact on management of patients with HCV infection? Here’s my take.

Genotype 1
Viekirax safety, efficacy comparable in HCV with chronic kidney ...
Healio
The safety and efficacy of Viekirax was comparable between patients with hepatitis C genotype 1b and chronic kidney disease and those without chronic kidney disease, according to a recently published study. “The HCV infection rate in CKD patients is higher than that in the general population, and the anti-HCV ...

Jan 10
Genotype 1
Full Text
Viekira Pak - Effect of ombitasvir/paritaprevir/ritonavir + dasabuvir regimen on health-related quality of life for patients with hepatitis C
During active treatment period, small but statistically significant decrements in HRQoL outcomes were observed potentially driven by RBV, which were not sustained during the post treatment follow up period. Differences were observed by patient subgenotype, where HRQoL improvements were consistently higher for GT1b patients as compared to GT1a patients

Jan 6
Genotype 3
Full Text
In summary, SURVEYOR-II Part 3 enrolled and treated some of the most difficult-to-cure HCV patients: those with GT3 infection and prior treatment experience and/or cirrhosis. Overall, the fixed-dose combination of once-daily RBV-free G/P was well tolerated and demonstrated high SVR12 rates (≥95%) in treatment-naive patients with cirrhosis treated for 12 weeks and treatment-experienced patients with or without cirrhosis treated for 16 weeks. Therefore, G/P provides an efficacious and well-tolerated once-daily RBV-free treatment option for patients with HCV genotype 3 and prior treatment experience and/or cirrhosis.

In Case You Missed It
Genotype 1,2, and 3
Full Text
CMAJ - January 5, 2018 vol. 6 no. 1 E12-E18
Real-world treatment of hepatitis C with second-generation direct-acting antivirals: initial results from a multicentre Canadian retrospective cohort of diverse patients
High hepatitis C cure rates have been observed in registration trials with second-generation direct-acting antivirals. Real-world data also indicate high sustained viral response (SVR) rates. Our objective was to determine real-world SVR rates for patients infected with hepatitis C virus (HCV) who were treated with second-generation direct-acting antivirals in the first 18 months of their availability in Canada. *Click image to enlarge, view full text article online, here or download PDF. 

Sustained viral response status by genotype and treatment regimen


Jan 5
2018 Year in Review - Hepatitis Newsletters, Headlines & Updates
Welcome folks, for a recap of this year's HCV accomplishments check out the following newsletter, blog and journal updates.

Genotype 1 and 6
Abstract - Sofosbuvir-ledipasvir with or without ribavirin for chronic hepatitis C genotypes 1 and 6: real-world experience in Vietnam
There was no significant difference in demographic data and treatment outcomes between patients with genotype 1 versus 6. Adverse events were mild with all SOF-LDV regimens, but appeared to be more common with 24-week treatment groups.

Conclusions: SOF-LDV with or without RBV was highly effective and safe in Vietnamese patients with HCV genotype 1 and 6.

Jan 1
Genotype 6
HCV Genotype 6 Responds to 8-Week Oral Treatment
The successful treatment of hepatitis C virus genotype 6 (HCV-GT6) with a non-interferon-based fixed dose oral regimen of ledipasvir and sofosbuvir (LDV/SOF) bodes well for treating HCV in Southeast Asia, where newer pangenotypic agents are not available to treat this region's most prevalent genotype.

The Long Road To Safe and Effective HCV Drugs: A Tribute To The People Who Helped Us Get There
Before we look ahead to 2018, I thought we might look back. Why? So that we may never forget just how far we've come, and the people who helped us get there.

20th Anniversary Edition of HCV Advocate's Newsletter 
IN THIS ISSUE
Celebrating 20 Years
Honoring Twenty Years of Hepatitis C Advocacy
Top Ten Stories
A Year in the Life of a Trainer

Full Text
Viral kinetics analysis & virological characterization of treatment failures in a real-world cohort with chronic HCV treated with SOF & an NS5A inhibitor (DCV or LDV)
This real-world study confirms the excellent results of clinical trials with therapies based on a combination of SOF plus an NS5A inhibitor. It suggests that a personalized approach including baseline NS5A inhibitor resistance testing may inform treatment decisions in cirrhotic patients.
Full-text article shared by @HenryEChang via Twitter
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