Direct antiviral agents may hold the key to eradication, but only if they reach those who will benefit
In this issue of the Journal, Dore outlines the astonishing recent progress in the treatment of hepatitis C virus (HCV) infection,1 largely triggered by the approval in 2011 by regulatory bodies, both overseas and in Australia, of the first two direct antiviral agents (DAAs) against HCV. These two agents, telaprevir and boceprevir, only target genotype 1 HCV and are used in combination with the current standard of care — pegylated interferon and ribavirin. This triple-therapy combination represents two main advances: an increase in sustained virological response (SVR) from 45% to 70%, and a shortened duration of treatment from 12 to 6 months in about 50% of patients. However, these benefits come with an increased side-effect profile compared with the current standard of care. In fact, the results from the current standard of care in Australia are also published in this issue of the Journal and reflect world’s best practice in treating patients with HCV infection.2
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- 1. Dore G. The changing therapeutic landscape for hepatitis C. Med J Aust 2012; 196: 629-632.
- 2. Gidding HF, Law MG, Amin J, et al. Hepatitis C treatment outcomes in Australian clinics. Med J Aust 2012; 196: 633-637.
- 3. Hellard M, Jenkinson R, Higgs P, et al. Modelling the utility of antiviral treatment for primary prevention of hepatitis C infection among people who inject drugs in Victoria, Australia. Med J Aust 2012; 196: 638-641.
- 4. Gidding HF, Law MG, Amin J, et al. Predictors of deferral of treatment for hepatitis C infection in Australian clinics. Med J Aust 2011; 194: 398-402. <MJA full text>
- 5. Innes H, Hutchinson SJ, Allen S, et al. Excess liver-related morbidity of chronic hepatitis C patients, who achieve a sustained viral response, and are discharged from care. Hepatology 2011; 54: 1547-1558.
I am a member of the Gilead, Janssen-Cilag, and Merck Sharp and Dohme advisory boards, and have received consultancy payments from these companies.