Hepatitis News

Promising results from new hepatitis C drugs

Hepatitis C treatment may be revolutionised in a couple of years, researchers predict, as promising results start to come through from trials of new oral drugs that target viral enzymes in a similar way to HIV drugs.

These drugs do not remove hepatitis C from the body and will have to be combined with the existing pegylated interferon/ribavirin therapy in order to cure hepatitis C virus (HCV) infection. However they may more than double the chance of a cure and may also shorten the course of therapy.

In addition, new versions of interferon are being developed that are more tolerable and need to be injected less often.

The latest results come from a trial of the hepatitis C protease inhibitor boceprivir. This trial, in over 800 patients with the most difficult to treat type of HCV, genotype 1, is ongoing and we only have results for 595 patients in the first twelve weeks of therapy.

In these, nearly 80 per cent of patients treated initially with pegylated interferon alfa 2b (PegIntron) and ribavirin had already achieved an undetectable HCV viral load after 12 weeks of therapy compared with 38% not taking boceprivir.

Results were somewhat better if boceprivir was added four weeks after patients were started on PegIntron/ribavirin (79% undetectable) than if they started boceprivir immediately (70% undetectable). This may be due to a slightly increased risk of bad side effects in patients starting boceprivir immediately: one in eight patients had to discontinue therapy in this group compared with one in eleven who staggered their drugs. The most common side effects reported were fatigue, headache, nausea and anaemia – similar to standard HCV therapy.

New versions of interferon may also make HCV treatment both more tolerable and more successful. Albuferon is a new type of interferon that only has to be injected once a month compared with once a week. In a small study of patients with the easier-to-treat versions of HCV, genotypes 2 and 3, 77% of patients taking albuforn monthly achieved a Sustained Viral Response (i.e. a cure) compared with 62% taking the same drug fortmightly. Again, this was due to difference in the rate of side effects, with three times as many patients on the fortnightly dose having to discontinue their medication (one in seven patients, compared with one in 22 on the monthly injections).

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