The Time to Test and Treat for HCV Is Now

February 27, 2015
Rodger D. MacArthur, MD
Rodger D. MacArthur, MD

Here is compelling reason why every MD needs to test his or her patients for HCV, and get them into therapy as soon as possible.

Now is the time to get tested and treated for HCV.

This was one of the main messages at multiple sessions today at the 2015 CROI in Seattle. That advice is especially true if the HCV-infected individual is older, co-infected with HIV, has more advanced fibrosis or cirrhosis, or has previously failed therapy with (ie, null responder to) pegylated interferon and ribavirin. Leaving aside the issue of cost, the already-approved, or soon-to-be-approved, directly acting agents (DAAs), when used in 2- or 3-drug combinations, result in 95% to 100% sustained virologic response rates (SVRs) at 12 or 24 weeks. And these impressive cure rates are holding up in the most difficult-to-treat populations, including the ones that I mentioned at the beginning of this paragraph.

In the US, there currently are 3 FDA-approved regimens that use DAAs. One other (daclatasvir) is likely to get approval soon. Briefly, these drugs are or will be approved in combination with other anti-HCV drugs (either other DAAs or ribavirin or pegylated interferon plus ribavirin) across a range of HCV genotypes and risk groups:

What we learned today, in a session titled, “Curing HCV: Mission Accomplished,” should prompt every MD to test his or her patients for HCV, and get them into therapy as soon as possible. Specifically:

We have the drugs available to cure HCV. Efforts now need to turn to identifying those infected and getting them into treatment.

References:

1. Klevens M, Huang X, Yeo AE, et al. The Burden of Liver Disease Among Persons With Hepatitis C in the United States. Abstract 145; 2015 CROI; Seattle; 23 – 26 February 2015.
2. Eron JJ, Trinh R, Lalezari J, et al. High SVR Regardless of Time to Suppression With ABT-450/r/Ombitasvir & Dasabuvir+RBV
David Wyles. Abstract 147; 2015 CROI; Seattle; 23 – 26 February 2015.
3. Zahnd C, Salazar-Vizcaya LP, Dufour J-F, et al. Impact of Deferring HCV Treatment on Liver-Related Events in HIV+ Patients. Abstract 150; 2015 CROI; Seattle; 23 – 26 February 2015.
4. Wyles D, Ruane P, Sulkowski, M, et al. Daclatasvir in Combination With Sofosbuvir for HIV/HCV Coinfection: ALLY-2 Study
David Wyles. Abstract 151LB; 2015 CROI; Seattle; 23 – 26 February 2015.
5. Naggie S, Cooper C, Saag MS, et al. Ledipasvir/Sofosbuvir for 12 Weeks in Patients Coinfected With HCV and HIV-1. Abstract 152LB; 2015 CROI; Seattle; 23 – 26 February 2015.