A medication combination can successfully treat genotype 3 hepatitis C infection.
AbbVie’s pangenotypic direct-acting antiviral combination of two drugs cured 95% of people with early-stage genotype 3 hepatitis C virus (HCV), the hardest genotype to treat, according to results of the ENDURANCE-3 trial presented at the International Liver Congress in Amsterdam on Friday.
The AbbVie second-generation direct-acting antiviral combination consists of a protease inhibitor and an NS5A inhibitor. Glecaprevir is an HCV NS3/4A protease inhibitor active against all genotypes of hepatitis C. Pibrentasvir is an NS5A inhibitor also active against all genotypes of hepatitis C.
A pangenotypic combination should be similarly effective against all genotypes of hepatitis C. To date, direct-acting antiviral combinations have tended to show somewhat lower efficacy in people with genotype 3, especially the hardest to treat – those with cirrhosis and those with previous experience of treatment.
The ENDURANCE-3 study was designed to test the combination of glecaprevir and pibrentasvir in people with genotype 3 infection without cirrhosis. This is the population that liver specialists can expect to see more of in their clinics as genotype 3 patients with cirrhosis are prioritised for treatment and cured, said Professor Graham Foster of Queen Mary University, London.
Genotype 3 is especially prevalent in South Asia and in South Asian populations in the United Kingdom, but these patients tend to have more advanced disease. Genotype 3 is also found in people who inject drugs, and most recent infections in Europe and North America occur in people who inject drugs.
“Genotype 3 is spreading in the US among young injectors, especially young men. For every patient that we treat and cure, that’s ten of his friends who don’t get infected,” said Prof. Foster.
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