Overcoming virus early beats hepatitis
DRIVING down the number of circulating copies of the hepatitis C virus to undetectable levels in the earliest stages of infection makes it highly likely that the patient will eventually be cured — even among patients who are also infected with HIV.
The findings, the interim results from an Australian study presented to a recent international conference in Italy, suggest that rapid virological response — or RVR, the term used to indicate successful suppression of viral load within four weeks of starting treatment — is just as good a predictor of eventual cure among patients suffering acute hepatitis C infection as it is already known to be among chronically infected individuals.
In addition, the trial — which is still continuing — suggests new treatment options for difficult-to-treat groups such as people with HIV and injecting drug users. Unlike most hepatitis C treatment studies, this research included significant numbers of HIV patients and injecting drug users, and the findings showed RVR was just as good at predicting eventual cure in these as in other patients.
The Australian Trial in Acute Hepatitis C, known by its acronym ATAHC, was funded by the US National Institutes of Health. The interim findings were presented as a poster at the recent annual scientific meeting of the European Association for the Study of the Liver in Milan, where it was voted into the top 10 per cent of the more than 800 poster presentations at the meeting.
An estimated 264,000 Australians have been exposed to hepatitis C, a blood-borne virus that attacks the liver and left untreated can lead to liver inflammation, cirrhosis and eventually cancer.
Although 25 per cent of people clear the virus naturally, the prognosis for the remaining 75 per cent is more difficult as most will usually experience symptoms such as debilitating fatigue, pain and nausea.
While cure is possible with drug therapy, the drugs are quite toxic and hard to tolerate. Treatment also lasts a year and only works in fewer than 50 per cent of cases. Co-infection with HIV makes it even harder to eradicate hepatitis C.
Sydney-based hepatitis expert Greg Dore, a co-author of the study and who attended the Milan conference, said the message from the ATAHC findings was that if doctors could drive viral levels down to undetectable levels early ‘‘ you can get incredibly good response rates’’.
While 107 patients in the study elected to have treatment for acute hepatitis C, 84 patients continued to the point where they