Hep C health revolution?

The Medical Journal of Australia (MJA) has asked whether chronic hepatitis C (HCV) infection in Australia may soon become a thing of the past.

“Is the end of chronic hepatitis C virus infection in sight?” an editorial in the MJA by Royal Prince Alfred Hospital AW Morrow Gastroenterology and Liver Centre head Geoffrey McCaughan asks.

The Kirby Institute’s Viral Hepatitis Clinical Research Program head Professor Gregory Dore had written in the same issue that the next decade would be a crucial period in the public health response to HCV, which would initially see the use of new triple therapies combining interferon, ribavirin and protease inhibitors.

These treatments would be more toxic, meaning patients would need to be monitored carefully. But eventually safer and simpler interferon-free treatments would become available.

“The rapid development of direct-acting antiviral therapy for HCV infection has brought considerable optimism to the HCV sector, with the realistic hope that therapeutic intervention will soon be more effective and offer shorter treatment duration,” Dore wrote.

“Over the course of the decade, strategies … with enhanced tolerability and simplified dosing schedules and monitoring protocols will emerge.”

Dore wrote that he expected simple daily oral dose treatments with shorter durations of between six – 24 weeks and cure rates higher than 90 percent to emerge before 2020.

Currently patients may need to receive treatment for up to 48 weeks.

“The broad implementation of such therapeutic regimens has the potential to produce one of the major turnarounds in disease burden seen in public health and clinical medicine,” Dore wrote.

“The potential for HCV treatment as a prevention tool … may also become a feasible public health strategy.”

In the last two years a rise in the number of HIV positive men who have sex with men contracting HCV has been detected and HIV positive gay men have higher rates of HCV infection than the general population.