Personalized Hepatitis C Antiviral Drug Therapy Could Eliminate Virus

In order to eradicate hepatitis C virus (HCV) from a patient’s body, the right combinations of direct-acting antivirals (DAAs) must be chosen, a recent study found.

The German study enrolled 310 patients who did not respond to DAAs from a large European HCV DAA-resistance database. Patients were only eligible if they received interferon-free DAA regimens.

Of the 310 patients, 84% with HCV genotype 1 developed resistance associated variants, while 42% of genotype 3 patients did.

The researchers re-treated 29% (n=57/195) of patients with HCV genotype 1, most of whom failed treatment with the combination of simeprevir and sofosbuvir. Genotype 1 patients were re-treated with the combination of ledipasvir and sofosbuvir or paritaprevir, ombitasvir, and dasabuvir. SVR12 was achieved in 90% of HCV genotype 1 re-treated patients.

In the genotype 3 group, 23% (n=16/69) of patients were re-treated with sofosbuvir, daclatasvir ± ribavirin. All of the re-treated patients with available follow-up data achieved SVR12.

“The concept of failed hepatitis C treatment may be increasingly out of date,” said Frank Tacke, member of the EASL Governing Board. “It may indicate that we have not yet found the right combination of drugs to eradicate the virus in a particular patient. With the plethora of direct-acting antivirals available, the medical community must work to find the right combination of medicines for the right patient.”