Hepatitis C highlights from The Liver Meeting 2018

This year at The Liver Meeting, data presented on hepatitis C treatment highlighted continued significantly positive outcomes from direct-acting antiviral therapy, reduced rates of hepatocellular carcinoma, and improved outreach and screening techniques.

Healio Gastroenterology and Liver Disease has compiled the following reports which include presentations on nearly perfect sustained virologic response rates with Mavyret for 8 weeks, failure and retreatment outcomes in patients with NS5A substitutions, and results from a telemedicine program.

Preemptive DAA therapy improves outcomes of negative-to-positive HCV heart transplant

Preemptive administration of pangenotypic direct-acting antiviral therapy resulted in rapid viral suppression of hepatitis C in patients without HCV who received a heart transplantation with an HCV-positive organ, according to data presented at The Liver Meeting 2018.

“With the rising number of HCV-positive donors, there is a time-sensitive and critical need to document both the efficacy and detailed implementation strategies surrounding successful use of HCV-positive organs,” Emily Bethea, MD, Massachusetts General Hospital, said in her presentation. Read more

EXPEDITION-8: Mavyret nearly perfect in 8-week regimen

Mavyret yielded nearly perfect SVR rates after 8 weeks of therapy in compensated cirrhosis with HCV, according to data presented at The Liver Meeting 2018.

“Excellent real-world data confirms the high SVR data,” Robert S. Brown Jr., MD, of the Center for Liver Disease and Transplantation at New York Presbyterian Hospital and Cornell Medical College Department of Medicine, said. “The idea came to us to investigate an 8-week duration in treatment-naive patients with compensated cirrhosis, so we were looking at exactly that question.” Read more

NS5A substitutions affect early HCV treatment failures, retreatment

NS5A resistance-associated substitutions at several positions, including Y93, may hold information about DAA treatment response, according to data presented at The Liver Meeting 2018.

Masayuki Kurosaki , MD, of the Department of Gastroenterology and Hepatology at Musashino Red Cross Hospital, Tokyo, Japan, suggested that in addition to suboptimal results to the first-generation DAA combination of Daklinza (daclatasvir/DCV, Bristol-Myers Squibb) and Sunvepra (asunaprevir/ASV, Bristol-Myers Squibb), early data showed that the Y93 RAS was associated with lower treatment response. Read more

DAAs reduce HCC, decompensation risk compared with no treatment

Individuals with hepatitis C who underwent DAA therapy experienced significant reductions in both hepatocellular carcinoma and decompensation risk compared with untreated patients, according to data presented at The Liver Meeting 2018.

Haesuk Park, MD, assistant professor in the College of Pharmacy at the University of Florida, aimed to determine the impact of all-oral DAA treatment on the incidence rate of HCC and decompensated cirrhosis, along with the economic outcomes of DAA treatment. “We looked at liver-related costs, and all-cause costs,” Park said. Read more

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HCV telemedicine program satisfying, cost-effective in Spanish prison

A telemedicine program brought high levels of satisfaction and proved cost effective in patients with hepatitis C in a Spanish prison, according to data presented at The Liver Meeting 2018.

Susana Llerena , MD, of the Hepatology Unit at Marques De Valdecilla University Hospital in Spain, and colleagues aimed to assess whether a telemedicine program could be useful in eliminating HCV in the El Dueso Penitentiary Center in Cantabria, Spain. Read more

HCV reinfection uncommon in injection drug users after treatment

Despite continued drug use, hepatitis C reinfection rarely occurred in a cohort of patients with HCV who received opioid agonist therapy and were treated for HCV, according to findings presented at The Liver Meeting 2018.

Jason Grebely, PhD, of The Kirby Institute at the UNSW Sydney, Australia, and colleagues, aimed to further analyze HCV reinfection patterns as they associate with injection drug use risk behavior in a cohort of patients who completed the Co-STAR Part A study. Read more

Universal screening for HCV superior to risk-based approach in pregnant women

Universal screening of pregnant women at risk for hepatitis C was more efficient and cost-effective compared with risk-based screening, according to data presented at The Liver Meeting 2018.

“Our study was prompted by this combination of what was happening with the opioid epidemic and the very high number of young women testing positive for hepatitis C,” Michelle Rose, MBA, population health manager from Norton Healthcare in Kentucky, said during a press conference presentation. “The numbers reached a point that ... it was operationally and medically more sensical to universally screen.” Read more