April 17, 2012
Paul E. Sax, M.D., is director of the HIV Program and Division of Infectious Diseases at Brigham and Women's Hospital in Boston.
I can't think of a single upcoming scientific meeting in ID that's likely to be more "game changing" -- sorry for the tired metaphor -- than the 47th European Association for the Study of the Liver (EASL) meeting, which starts tomorrow in Barcelona.
As a hint of what's to come, earlier this month Abbott released these data on two studies of interferon-free treatments:
In the study known as "Co-Pilot," different doses of ABT-450/r [a boosted HCV protease inhibitor], plus ABT-333 [a polymerase inhibitor] and ribavirin administered for 12 weeks showed sustained virological response at 12 weeks post treatment (SVR12) in 95 percent and 93 percent of treatment-naive genotype 1 (GT1) patients. In addition, SVR12 was achieved in 47 percent of patients who were previous non-responders to past HCV treatment ... In a separate study, known as "Pilot," 91 percent of genotype 1 infected, treatment-naive patients taking ABT-450/r and ABT-072 combined with ribavirin administered for 12 weeks, achieved sustained viral response at 24 weeks (SVR24).
To recap: That's a > 90% cure rate for interferon-free, all oral regimens given for 12 weeks.
Mind you, these are just three small studies that could completely change how we treat this infection.
How many more like it are in the wings?
The bottom line is that anyone planning to start a patient on interferon-based HCV treatment today should weigh -- very carefully -- the pros and cons of treating now, vs waiting a couple of years for what will undoubtedly be superior regimens.
Paul Sax is Clinical Director of Infectious Diseases at Brigham and Women's Hospital. His blog HIV and ID Observations is part of Journal Watch, where he is Editor-in-Chief of Journal Watch AIDS Clinical Care.