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Hepatitis Patients Respond Equally Well to Short Course Treatment

The hepatitis C virus is a leading cause of liver disease, sickening nearly 200 million people worldwide. Now, researchers report they can cure the chronic infection in a majority of cases with a shorter course of anti-viral drugs.

Nearly 200 million people - about three percent of the world’s population - are infected with hepatitis C. The virus is transmitted primarily through shared needles or contaminated blood transfusions, but could also be spread anywhere unsterilized tools are used such as at some tattoo parlors, nail salons or dentists offices.

While many cases of hepatitis C, or HCV, do not progress into serious illness, experts say the disease in its chronic form can lead to liver cancer, or damage called cirrhosis that keeps the liver from working properly, resulting eventually in liver failure.

But Michael Fried, a professor of medicine at the University of North Carolina in Chapel Hill, says about 75 percent of H-C-V cases can now be cured with antiviral drugs.

“So that’s very encouraging. And we know that permanent eradication of hepatitis C does lead subsequently to long-term clinical improvement with less likelihood of developing cirrhosis and liver cancer,” Fried said.

Doctors consider a patient cured of hepatitis C if blood tests results are consistently negative six months after completing therapy.

In a multicenter study involving 540 patients with chronic hepatitis C across the United States and in Amsterdam and Brussels, participants were initially treated with three drugs, including peginterferon and ribavirin.

Three-hundred-fifty-two patients had a rapid response, and showed no genetic evidence of the virus in their blood after four weeks of treatments.

Researchers then randomly assigned these patients to an additional twelve weeks of peginterferon and ribavirin or 36 more weeks of the combination therapy.

Investigators wanted to see whether patients on the shorter treatment regimen of 24 weeks did just as well as those receiving the drugs for 48 weeks, which is the standard course, according to Fried.

“And what we found was the extended treatment out to 48 weeks did not provide any added benefit over the group that got 24 weeks,” said Fried.

Fried says the key to success with the shorter duration treatment appears to be that patients had an initial rapid response to the drugs, something that occurred in about two-thirds of the patients in the study.

That means that a majority of hepatitis C patients, according to Fried, could potentially benefit from the shorter treatment regimen, minimizing the side effects of the treatment.

“Fortunately, most of them are mild or moderate and can be managed. But anytime you can shorten a course of therapy, you are exposing the patients to less potential for side effects. In addition, the costs would be less because you would have a shorter duration of therapy for the majority of patients.”

An article on the treatment of hepatitis C is published in the New England Journal of Medicine.