What should happen with a hepatitis C patient who relapses after treatment? Well, giving up is certainly not the answer. Retreatment – or “salvage therapy” as it’s known – might be able to cure many if not all of these patients.
Anita Kohli, M.D., from the U.S. National Institute of Allergy and Infectious Diseases (NIAID), along with fellow scientists, shared research recently that demonstrates how not giving up can bring a cure to hepatitis C cases that, at first, seemed hopeless. Dr. Kohli enrolled 14 patients with genotype 1 hepatitis C into a clinical trial after they had been treated with Sovaldi® (sofosbuvir) and ribavirin for 24 weeks. After this treatment, all 14 had relapsed and continued to be infected with the hepatitis C virus (HCV).
The new treatment in these relapsed patients was a 12-week course of Sovaldi with ledipasvir. This medication combination is now approved by the U.S. Food and Drug Administration (FDA) and goes by the name Harvoni®. The retreatment was successful in all 14 patients; they all achieved a sustained virologic response (SVR) after the 12-week medication course. This success is even more impressive considering that seven of the patients had advanced liver disease and one of the patients had a detectable NS5B S282T mutation. This mutation is associated with resistance to Sovaldi. None of the patients experienced side effects that would lead to the discontinuation of treatment.
The fact is that these patients can’t afford to wait for more research. Patients who have failed treatment and have advanced liver disease are on the road to needing a liver transplant (and livers available for transplant are few and far between). This phase 2 clinical trial offers a glimmer of hope – a second chance – for patients who did not achieve a cure during their initial treatment. Harvoni should be considered for patients who are not cured the first time around.