November 10, 2011
Paul E. Sax, M.D., is director of the HIV Program and Division of Infectious Diseases at Brigham and Women's Hospital in Boston.
I didn't attend "The Liver Meeting" (the nickname for the annual meeting of the American Association for the Study of Liver Diseases, AASLD), but the studies presented there this week on HCV treatment were absolutely mind-boggling.
"Breathtaking!" said one of my HCV-oriented colleagues. "Hopeful is an understatement," said another.
Dual Oral Combination Therapy with the NS5A Inhibitor Daclatasvir (DCV; BMS-790052) and the NS3 Protease Inhibitor Asunaprevir (ASV; BMS-650032) Achieved 90% Sustained Virologic Response (SVR12) in Japanese HCV Genotype 1b-Infected Null Responders
Mind you, this was only 10 patients, but 9/10 is no fluke -- especially when all the responders had HCV RNA below detection by week 8, and all 9 who completed 24 weeks were cured!
Want a larger study?
PROTON: PSI-7977 & Peg/RBV in Treatment-naïve Patients with HCV GT1: Sustained Virologic Response
Here, in nearly 100 patients, the addition of 12 weeks of the nucleotide analogue polymerase inhibitor PSI-7977 to Peg/RBV led to a cure rate of over 90%, regardless of baseline IL-28B status (13/13 cured with genotype TT). Works with other HCV genotypes, too.
I chose these two studies in particular because the companies developing these drugs -- BMS and Pharmasset -- are working together on a prospective study that features all-oral, interferon-less strategies lasting only 12 weeks.
But there's plenty more. Don't take my word for it -- go over to NATAP, click on the "Hepatitis C" link on the left, and start reading.
And if you have limited time, and want a glimpse of the future of HCV therapy, limit your search to studies that say "interferon-free".
Paul Sax is Clinical Director of Infectious Diseases at Brigham and Women's Hospital. His blog HIV and ID Observations is part of Journal Watch, where he is Editor-in-Chief of Journal Watch AIDS Clinical Care.
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