Advances in Hepatitis C Infection

On the fourth day of APASL, Professor Michael P. Manns presented a lecture on advances in hepatitis C infection. He said that in recent years, therapy for hepatitis C had been optimized by individualizing of treatment according to genotype and early treatment response. Achieving rapid virological respons (RVR) can shortern the duration of treatment. For all genotype 1 patients, early virological response (EVR) has become a very important to guide treatment. If they do not achieve EVR, treatment is stopped since success rates are minimal. The final goal of treatment is to achieve sustained virological response (SVR). It has been shown that relapse rates in patients achieving SVR are extremely rare.

He also mentioned small direct antiviral molecules, in particular HCV protease and polymerase inhibitors were under clinical development. These new drugs in combination with standard of care will reduce the duration of treatment in genotype 1 patients as well as improve the overall cure rates. For instance, the protease inhibitors, Telaprevir and Boceprevir are very promising to reduce duration of treatment from 24~48 weeks and improve SVR rates to 55%~65% in these patients. Hopefully, they also will help cure HCV in non-responders or relapsers to previous standard of care. Telaprevir in combination with standard of care made 41% of non-respnders and 75% of relapsers achieve SVR.