New and Noteworthy
- Grazoprevir and elbasvir effective in people who have never been treated before
- 90% cure rate in people with advanced liver injury with grazoprevir and elbasvir
- High levels of alcohol use predicts severe liver injury and death in people with hepatitis C
Grazoprevir and elbasvir effective in people who have never been treated before
In a late-stage trial, 12 weeks of grazoprevir and elbasvir cured 95% of previously untreated (treatment naïve) people with genotypes 1, 4 or 6 virus, reported researchers at the European Association for the Study of the Liver (EASL) 50th International Liver Congress.
Grazoprevir and elbasvir are both direct-acting antivirals (DAAs). DAAs are a group of medications that directly attack the ability of a virus to make copies of itself. These medications are in the experimental stage and have not been approved in Canada.
Grazoprevir and elbasvir are being studied as a combination in one pill that is taken once per day.
The cure rates were all high, but differed somewhat by viral genotype:
- Genotype 1a, 92%
- Genotype 1b, 99%
- Genotype 4, 100%
- Genotype 6, 80%
The combination was generally well tolerated with headache, nausea, fatigue and joint pain being the most common side effects.
Other studies have found high cure rates when testing grazoprevir and elbasvir in people who are treatment experienced and people with HIV and Hep C co-infection. (HIVandhepatitis.com, April 2015, in English)
90% cure rate in people with advanced liver injury with grazoprevir and elbasvir
In a small mid-stage trial, 12 weeks of grazoprevir and elbasvir cured Hep C infection among 90% of people with very advanced liver injury, reported researchers at the European Association for the Study of the Liver (EASL) 50th International Liver Congress.
The participants in this study included people with a Child-Pugh class B score and people without advanced liver injury (cirrhosis) as a control group. Child-Pugh Class A, B and C are measurements of cirrhosis. Child-Pugh B and C are more severe forms of cirrhosis.
Participants had either genotypes 1, 4 or 6 virus. All participants were white and the majority were men.
Participants with Child-Pugh B scores had a cure rate of 95%, and people without cirrhosis had a cure rate of 100%.
Side effects were similar in the group with Child-Pugh B scores compared to participants without cirrhosis. The one exception was that some participants with Child-Pugh B scores had high bilirubin scores.
Bilirubin is a chemical that is usually processed by the liver as it breaks down old red blood cells. If the liver is unable to keep up, bilirubin can build up in the body, causing the skin to look yellow. This resolved after treatment ended. (HIVandhepatitis.com, April 2015, in English)
High levels of alcohol use predicts severe liver injury and death in people with hepatitis C
According to a French study, people with hepatitis C who have an alcohol use disorder or an additional serious health condition have a greater risk of liver-related hospitalization or death, reported researchers at the European Association for the Study of the Liver (EASL) 50th International Liver Congress.
The researchers analysed the records of all people hospitalized in France between 2008 and 2012.
46% of all liver-related events in people with hepatitis C occurred in people with alcohol use disorders. Approximately, one-third occurred in people with hepatitis C who had another serious health condition such as HIV, chronic kidney disease or cancer. Only 14% of liver-related events occurred in people who did not have an alcohol use disorder or an additional serious health issue.
Among people with hepatitis C, one-third of all deaths in hospital occurred in people with alcohol use disorders and 57% in people with other serious health conditions.
According to one member of EASL, “These results show that alcohol use disorders are a much more accurate indicator of mortality in chronic HCV infection, and highlight the need to encourage alcohol withdrawal and abstinence in all patients,” (aidsmap.com, April 2015, in English)