Interferon-free therapies for hep C virus look promising

(HealthDay)—For untreated patients with hepatitis C virus (HCV), treatment with an oral nucleotide inhibitor of HCV polymerase, sofosbuvir, plus ribavirin seems effective for genotypes 1, 2, and 3; and the HCV NS3 protease inhibitor ABT-450, combined with low-dose ritonavir (ABT-450/r) plus the nonnucleoside NS5B polymerase inhibitor ABT-333 and ribavirin, seems effective for genotype 1, according to two studies published in the Jan. 2 issue of the New England Journal of Medicine.

Edward J. Gane, M.D., from Auckland City Hospital in New Zealand, and colleagues evaluated sofosbuvir in interferon-sparing and interferon-free regimens for patients with untreated HCV genotype 2 and 3. After 24 weeks of therapy, the researchers found that all patients who received sofosbuvir plus ribavirin without interferon or with interferon had a sustained virologic response. In addition, 84 percent of previously untreated patients with HCV genotype 1 had a sustained virologic response with sofosbuvir and ribavirin.

In a second study, Fred Poordad, M.D., from the University of Texas Health Science Center in San Antonio, and colleagues assessed the role of ABT-450/r, ABT-333, and ribavirin for treatment of HCV 1 infection without cirrhosis in a 12-week phase 2a study. The researchers found that most untreated patients had an extended rapid virologic response, and 93 to 95 percent had a sustained virologic response 12 weeks after the end of treatment. Forty-seven percent of those who had had a null or partial response to previous therapy with peginterferon and ribavirin had sustained virologic response 12 weeks after therapy.

"This preliminary study suggests that 12 weeks of therapy with a combination of a protease inhibitor, a nonnucleoside polymerase inhibitor, and ribavirin may be effective for treatment of HCV genotype 1 infection," Poordad and colleagues conclude.

The Gane study was supported by Pharmasset and Gilead Sciences; the Poordad study was funded by Abbott.