Interferon as a component of hepatitis C treatment is almost becoming a memory. The new treatments appropriate for many hepatitis C patients offer a cure without the side effect-heavy specter of interferon. In fact, 90-100% of patients on these interferon-free regimens will reach sustained virologic response – which essentially means they are cured.
Yet challenges do remain in the hepatitis field. Certainly issues surrounding the high cost of the new treatments will continue to be sorted out by stakeholders. As the new medications continue to be researched and better understood, we will be learning more about the optimal duration for various combinations of medications – especially for each genotype of infection and for treatment-naïve and treatment-experienced patients.
Most medications were tested first as a treatment for genotype 1 infections, which makes sense since this genotype is most prevalent worldwide at 50% of cases and overwhelmingly most prevalent in the U.S. (70% of cases). But what about the rest of the patients who are infected with genotypes 2-7? Fortunately, research continues to pour in about the potential of interferon-free therapies for these other genotypes. For example, research published in The Lancet showed good results with an interferon-free treatment of genotype 4 with Viekira Pak (ombitasvir/paritaprevir plus ritonavir), either with or without ribavirin.
The research climate looks more positive than ever for a future without interferon – potentially for all genotypes.
Blazek N. Challenges remain in HCV treatment despite advances. Clinical Advisor June 24, 2015.
Hezode C, Asselah T, Reddy KR, et al. Ombitasvir plus paritaprevir plus ritonavir with or without ribavirin in treatment-naive and treatment-experienced patients with genotype 4 chronic hepatitis C virus infection (PEARL-I): a randomised, open-label trial. The Lancet 2015;385:2502-9.
Wedemeyer H. Towards interferon-free treatment for all HCV genotypes. The Lancet 2015;385(9986):2443-5.