Grazoprevir/Elbasvir Superior to Sofosbuvir Plus Pegylated Interferon New research has demonstrated the clear superiority of an oral combination of direct-acting antivirals (DAAs) over a regimen that combines a DAA with pegylated interferon and ribavirin for the treatment of chronic hepatitis C virus (HCV) infection. Results from the C-EDGE Head-to-Head study were presented at the recent EASL International Liver Congress in Barcelona. WHO Issues New Hepatitis C Guidelines, EASL Guidelines Update Coming In April, coinciding with the International Liver Congress in Barcelona, the World Health Organization (WHO) released an update to its Guidelines for the Screening, Care and Treatment of Patients with Chronic Hepatitis C Infection. The guidelines promote the transition to newer, more effective direct-acting antiviral (DAA) medications that have the potential to cure most people living with hepatitis C. Also during the meeting the European Association for the Study of the Liver (EASL) announced it would update its hepatitis C treatment guidelines at a special conference in September. ABT-493 + ABT-530 Works Well for Patients Who Did Not Respond to Prior DAA Therapy An experimental combination of direct acting antivirals (DAAs) from AbbVie is effective and safe in patients with hepatitis C virus (HCV) genotype 1 who did not respond to previous DAA therapy, according to research presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) last month in Barcelona. Between 86% and 100% of patients achieved sustained virological response and the combination worked well in the context of pre-existing resistance mutations. HCV Therapy Improves Quality of Life for People Who Inject Drugs, But Reinfection Risk Remains People on opiate substitution therapy can be successfully treated with grazoprevir/elbasvir (Zepatier), leading to improvements in some aspects of quality of life, according to findings from the C-EDGE CO-STAR study presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) last month in Barcelona. However, the same study saw several cases of hepatitis C virus (HCV) reinfection after a cure, suggesting a greater emphasis on prevention may be warranted. Portugal's Roll-Out of Hepatitis C DAA Therapy Achieves Impressive Outcomes Roll-out of hepatitis C therapy using direct-acting antivirals (DAAs) has achieved excellent outcomes in Portugal, data presented to the International Liver Congress in Barcelona shows. Overall, 96% of treated patients had a sustained virological response (SVR) to therapy, with a 100% response rate seen in some sub-groups. Treatment also worked well for people with liver cirrhosis and treatment response was unaffected by HIV coinfection, previous hepatitis C therapy, or older age. AbbVie Pangenotypic Combination Achieves High Cure Rate for Genotype 3 Hepatitis C A new combination of direct-acting antivirals developed by AbbVie -- ABT493 and ABT-530 -- is highly effective in curing people with genotype 3 hepatitis C virus (HCV) infection and liver cirrhosis, according to results from a pair of Phase 2 studies presented at last week’s EASL International Liver Congress (EASL 2016) in Barcelona. DAAs for Hepatitis C Achieve Excellent Outcomes in Real-World Settings Hepatitis C therapy with direct acting antivirals (DAAs) is as effective in real-world settings as it was in clinical trials, according to U.S. research presented at the International Liver Congress in Barcelona last week. Investigators from the Department of Veteran Affairs (VA) analyzed outcomes in over 9000 patients treated with DAA combinations. Outcomes were excellent, with 2 combinations achieving cure rates of 93%, similar to those seen in randomized studies with strict eligibility criteria and close follow-up. Adolescents with Hepatitis C Achieve High Cure Rates with Sofosbuvir/Ledipasvir Sofosbuvir/ledipasvir (Harvoni) was well-tolerated and led to sustained virological response in 97% of adolescents (age 12-17) with chronic hepatitis C, with high cure rates regardless of prior treatment experience or presence of liver cirrhosis, according to a report presented at the 2016 EASL International Liver Congress in Barcelona. Novel Therapy RG-101 Plus Antivirals Could Cure Hepatitis C in 4 Weeks Two injections of RG-101, an experimental drug that targets the micro RNA miR-122 in liver cells, combined with direct-acting antiviral agents (DAAs) taken for just 4 weeks led to 12-week post-treatment sustained response in 97% of chronic hepatitis C patients, according to study results presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) last week in Barcelona. Sofosbuvir/Ledipasvir for 6 Weeks Cures Acute Hepatitis C in HIV-Negative People A regimen of sofosbuvir/ledipasvir (Harvoni) taken for 6 weeks cured all patients with genotype 1 acute hepatitis C virus (HCV) infection, including those with high viral loads, according to findings from a German study presented this week at the 2016 EASL International Liver Congress in Barcelona. The researchers said treating hepatitis C early with a short regimen would improve symptoms sooner, prevent HCV transmission, and cost less than treatment initiated during chronic infection. Sofosbuvir, Velpatasvir, and GS-9857 Works Well for Treatment-Experienced HCV Patients A triple combination of Gilead Sciences' sofosbuvir, velpatasvir, and GS-9857 demonstrated a high sustained response rate for treatment-experienced people with all hepatitis C virus (HCV) genotypes who previously were not cured with prior direct-acting antivirals (DAAs), according to 2 presentations at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) this week in Barcelona. Shifting Hepatitis C Treatment to Primary Care Providers Could Expand Availability Hepatitis C treatment managed by non-specialists such as primary care physicians and nurse practitioners is as safe and effective as treatment delivered by specialists -- even for challenging patient groups -- and could help increase the number of people receiving therapy, according to findings from the ASCEND study presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) this week in Barcelona. Vaccines for HIV and Hepatitis C Could Potentially Be Administered Together Immunization against HIV and hepatitis C virus (HCV) could potentially be combined without compromising immune response to either, though effective vaccines for both diseases are still elusive, according to research presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) last week in Barcelona. High Incidence of HCV Reinfection Among HIV+ Gay Men in Western Europe There is a very high incidence of hepatitis C virus (HCV) reinfection among HIV-positive men who have sex with men (MSM) in western Europe, according to research presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) this week in Barcelona. Investigators found that a quarter of HIV-positive gay men who cleared an initial HCV infection were reinfected within 3 years. The researchers believe that current prevention strategies are failing, and called for intensive monitoring of people who have apparently cleared HCV infection. Does Having HIV Affect Response to Hepatitis C Treatment? A study from the U.S. Veterans Health Administration found that HIV-positive people responded as well as those without HIV to direct-acting antiviral (DAA) therapy for hepatitis C, while a Spanish study showed that HIV/HCV coinfected people were less likely to be cured. These conflicting findings, presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) last month in Barcelona, indicate that the interactions between HIV and hepatitis C are still not fully understood. Sofosbuvir/Velpatasvir Cures 95% of HIV/HCV Coinfected People A dual regimen of sofosbuvir plus velpatasvir was well-tolerated and highly effective against hepatitis C virus (HCV) genotypes 1 through 4 in HIV-positive people with chronic hepatitis C coinfection, according to results from the Phase 3 ASTRAL-5 trial presented at the 2016 EASL International Liver Congress last week in Barcelona. High Incidence of HCV Reinfection Among HIV+ Gay Men in Western Europe There is a very high incidence of hepatitis C virus (HCV) reinfection among HIV-positive men who have sex with men (MSM) in western Europe, according to research presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) this week in Barcelona. Investigators found that a quarter of HIV-positive gay men who cleared an initial HCV infection were reinfected within 3 years. The researchers believe that current prevention strategies are failing, and called for intensive monitoring of people who have apparently cleared HCV infection. Hepatitis B Treatment Linked to Colorectal and Cervical Cancer People with hepatitis B who were treated with nucleoside/nucleotide antivirals did not have an overall higher rate of malignancies, but did show an increased incidence of colorectal and cervical cancer, underlining the need for regular screening, according to a study presented at the recent EASL International Liver Congress in Barcelona. Core Inhibitor NVR 3-778 Plus Pegylated Interferon Inhibits Hepatitis B Activity NVR 3-778, an experimental drug that interferes with hepatitis B virus (HBV) capsid assembly, led to reductions in HBV DNA, HBV RNA, and hepatitis B "e" antigen (HBeAg), showing greater activity when combined with pegylated interferon, researchers reported at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) last month in Barcelona. Antiviral Therapy Linked to Lower Liver Cancer and Mortality in People with Mild Hepatitis B Treatment with nucleoside/nucleotide antiviral therapy was associated with longer overall survival and reduced risk of developing liver cirrhosis and hepatocellular carcinoma (HCC) for hepatitis B patients with high viral load but minimal liver inflammation -- a group generally not prioritized for treatment --according to a report presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) last month in Barcelona. Tenofovir Alafenamide Works Well Against Hepatitis B with Less Effect on Bones and Kidneys The new tenofovir alafenamide (TAF) pro-drug is as potent against hepatitis B virus (HBV) as the current tenofovir disoproxil fumarate (TDF) formulation, but with less detrimental effects on bone and kidney biomarkers, according to a pair of studies presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) last week in Barcelona. Antiviral Therapy Linked to Lower Liver Cancer and Mortality in People with Mild Hepatitis B Treatment with nucleoside/nucleotide antiviral therapy was associated with longer overall survival and reduced risk of developing liver cirrhosis and hepatocellular carcinoma (HCC) for hepatitis B patients with high viral load but minimal liver inflammation -- a group generally not prioritized for treatment --according to a report presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) last month in Barcelona. People Treated for Hepatitis C Have Unexpectedly High Rate of Liver Cancer Recurrence Hepatitis C patients with cirrhosis who were treated with direct-acting antivirals had about twice the expected likelihood of developing hepatocellular carcinoma (HCC), with the excess risk seen in people with a previous history of HCC, according to research presented at the recent European Association for the Study of the Liver's International Liver Congress (EASL 2016) in Barcelona. These findings underline the importance of ongoing liver cancer monitoring even after successful hepatitis C treatment. Hepatitis C Treatment May Not Stop Progression to Advanced Liver Disease Doctors need to have full and frank discussions with patients about the potential risks and benefits of using direct-acting antivirals (DAAs) to treat hepatitis C in late-stage liver disease, especially among those waiting for a liver transplant, liver specialists said at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) this week in Barcelona. Emricasan May Improve Inflammation and Liver Function in People with Cirrhosis The novel caspase inhibitor emricasan (IDN-6556) led to improvements in various biomarkers and decreases in MELD scores in patients with liver cirrhosis due to hepatitis C, heavy alcohol use, or other causes, which significant declines among those who started with the worst liver dysfunction, according to a late-breaking presentation at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) last week in Barcelona. NorUrsodeoxycholic Acid Helps Rare Bile Duct Disease with No Current Treatment A Phase 2 European trial showed that norUrsodeoxycholic acid leads to a significant reduction in serum alkaline phosphatase in people with primary sclerosing cholangitis (PSC), a rare but serious bile duct disease, according to a report presented at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) last week in Barcelona. Cost of Eliminating Viral Hepatitis Must Consider Social as Well as Medical Factors Securing commitments from national governments to treat viral hepatitis, scale up prevention activities, and aim for elimination of hepatitis B and C by 2030 will require a broad coalition of forces -- and a sophisticated approach to proving the value of investing in elimination of viral hepatitis -- delegates heard at last month’s EASL International Liver Congress. How Generic Direct-Acting Antivirals Are Changing the Hepatitis C Treatment Landscape The arrival of generic versions of direct-acting antivirals (DAAs) is transforming the global hepatitis C treatment landscape and highlighting the overlooked importance of the cost of monitoring technologies, presenters said at the EASL International Liver Congress (EASL 2016) last week in Barcelona. Low-Cost Generic Hepatitis C Drugs Match Branded Products in Viral Response Generic versions of direct-acting antivirals for hepatitis C purchased from China and India by people unable to obtain treatment in their own countries were just as effective and safe as the branded products, a study of 139 patients monitored by Australian doctor James Freeman has shown. The findings were presented in a late-breaking research session at the European Association for the Study of the Liver's International Liver Congress (EASL 2016) in Barcelona on Saturday. Liver Associations Worldwide Call for Elimination of Viral Hepatitis Leaders of liver disease associations from Europe, the U.S., Latin America, and Asia released a Joint Society Statement on Elimination of Viral Hepatitis at the opening session of the International Liver Congress (EASL 2016) this week in Barcelona, calling for enhanced efforts to diagnose and treat hepatitis B and C, with the goal of eliminating viral hepatitis as a public health threat. $300 Hepatitis C Combination with Ravidasvir to Enter Clinical Trials The Drugs for Neglected Diseases Initiative (DNDi) is launching clinical trials in Thailand and Malaysia to test a combination of sofosbuvir and ravidasvir, an NS5A inhibitor, in at least 800 people with all genotypes of hepatitis C virus (HCV). The combination, manufactured by Egyptian company Pharco, could be made available for $300 for a course of treatment if it proves safe and effective, DNDi executive director Bernard Pécoul announced ahead of the 2016 EASL International Liver Congress this week in Barcelona. The studies will aim to test an affordable pangenotypic combination and to provide data for regulatory submission.