Barcelona (Spain): A pilot study has found that all patients with acute HCV who were treated with a direct-acting antiviral treatment over a ‘short-duration’ of six weeks had undetectable HCV after a 12 week follow-up.
The investigator-initiated study, presented on April 16 at The International Liver Congress in Barcelona, Spain, demonstrated that the combination of sofosbuvir and ledipasvir for only six weeks is sufficient to treat patients with acute HCV.
Those infected with HCV usually develop acute Hepatitis C, which spontaneously clears in 10 to 50% of infected persons. Early diagnosis of HCV infection is rare and the disease may go unnoticed until patients have already developed serious liver damage. Sofosbuvir and ledipasvir is one possible regimen for treatment of patients with chronic HCV. Sustained virologic response (SVR) is greater than 95% with a 12-week course of this treatment.
“Given the high cost of sofosbuvir and ledipasvir, and the associated side effects that occur during treatment, we set out to assess whether shortened treatment duration could be an effective option for acute Hepatitis C patients,” said Katja Deterding from Hannover Medical School, Germany and study author.
“Our research demonstrates that not only is the combination of sofosbuvir and ledipasvir safe, well tolerated and effective in acute HCV genotype 1 patients who have severe liver disease with very high liver enzymes, but a shorter treatment duration does not appear to hinder efficacy,” confirmed Professor Heiner Wedemeyer, the senior author of this study.
The German pilot study, performed by the German HepNet Study-House included 20 patients. Risk factors of HCV infection among the study members included; sexual transmission (n=11), medical procedures/needle stick injury (n=5), drug use (n=1), and nail treatment complications (n=1). The causes were unspecified for the remaining two patients.
All 20 patients completed six weeks of sofosbuvir and ledipasvir without ribavirin. At the 12-week follow up, all 20 patients had undetectable HCV and achieved SVR (100%). Fatigue was the most frequent side effect reported by study members (30%).
“These exciting findings open up short and cost-effective treatment options that could prevent the spread of HCV in high risk populations,” said Professor Frank Tacke, EASL Governing Board member. “We look forward to seeing this pilot study extended so the findings can be validated and then hopefully used as a tool to change clinical practice for the better.”