A new combination therapy allows chronic hepatitis C to be treated in a manner that is less aggressive yet equally efficient. This is the result of a current study, led by primary author Peter Ferenci from the University Department of Internal Medicine III at the MedUni Vienna, which has been published in the highly respected New England Journal of Medicine. "This is a revolutionary breakthrough in the treatment of this disease and represents a huge improvement in the quality of life of those affected," says the Vienna hepatologist.
Ferenci and a global group of scientists were able to demonstrate using 419 test subjects with chronic hepatitis C that the combined use of the protease inhibitor ABT-450r, the NS5A inhibitor Ombitasvir and the non-nucleoside polymerase inhibitor Dasubavir yields significantly higher cure outcomes than the previous therapy which involves Ribavarin and the hormone interferon (mostly in combination with a protease inhibitor). These therapies also had considerable side effects. The test subjects in these current "PEARL" studies were all in the early stages of the disease, i.e. before liver cirrhosis had developed.
Twelve weeks of treatment - almost a 100 per cent cure rate
Says Ferenci: "After just twelve weeks, we had achieved an almost one hundred per cent cure rate with this new, side-effect-free therapy." The therapy involves three tablets – two in the morning and one in the evening. Until now, patients with hepatitis C had to take Ribavirin and the hormone interferon for up to 18 months, and the side effects were considerable. "Often, additional treatment was and is necessary," explains Ferenci. With the new combination therapy, which is also free of interferon, this additional therapy is not required.
Around 170 million people worldwide suffer from chronic hepatitis C, and in Austria these numbers are between 40,000 and 80,000. In cases of new infection, prompt and targeted therapy is vital, as it can prevent the disease developing into a chronic condition that can lead to inoperable liver cancer. In the Clinical Gastroenterology and Hepatology Unit at the University Department of Internal Medicine III, several hundred patients with chronic hepatitis C are currently seen and treated each year.
Due to the low number of symptoms, infected individuals often mistake the disease for a 'flu-like infection. The condition is in many cases diagnosed by a chance finding.
Hepatitis C is an inflammation of the liver caused by an infection with the hepatitis C virus. The virus is transmitted mostly via direct contact with contaminated blood or blood products. At-risk groups are primarily drug abusers who share needles with others. Transmission through everyday activities is virtually impossible.
ABT-450/Ritonavir/Ombitasvir and Dasabuvir With or Without Ribavirin for HCV Genotype 1. P. Ferenci, D. Bernstein, J. Lalezari, D. Cohen, Y. Luo, C. Cooper, E.Tam, Rui T. Marinho, N. Tsai, A. Nyberg, T. D. Box, Z. Younes, P. Enayati, S. Green, Y. Baruch, B. Bhandari, F. Caruntu, T. Sepe, V. Chulanov, E. Janczewska, G. Rizzardini, J. Gervain, R. Planas, C. Moreno, T. Hassanein, W. Xie, M. King, T. Podsadecki and K. Reddy. New Engl. J. Med 2014 (in press). The complete article is available online: www.nejm.org/doi/full/10.1056/NEJMoa1402338