A pill containing two anti-viral drugs appears to cure currently untreatable hepatitis C, offering hope to patients at risk of serious liver damage and early death.
Although more work needs to be done to ensure the treatment is safe and effective, experts believe the early results could mark a turning point in tackling an intractable deadly disease.
In an early trial, the virus was eliminated from virtually every patient who took part, including those who had previously not responded to existing drugs.
Hepatitis C is a virus spread via blood and bodily fluids that damages the liver and often takes many years to produce symptoms. There is no vaccine that can prevent the infection, as there is for other forms of hepatitis.
Available treatments for hepatitis C consist of cocktails of powerful interferon and protease inhibitor drugs that have serious side-effects and involve complex regimes of pills and injections.
But in a significant number of cases involving the common genotype 1 strain of the virus, the drugs will not work. Patients whose infections cannot be cured may suffer potentially fatal cirrhosis damage to their livers or develop liver cancer.
The new treatment consists of a single pill containing the experimental drugs sofosbuvir and ledipasvir.
For the trial, 100 patients with genotype 1 hepatitis C were split into different groups and given the combination pill for either eight or 12 weeks.
One group of 40 had previously failed to respond to existing drugs, and just over half of them had cirrhotic livers.
Three months after completing the course of treatment, 97% of the patients had achieved a sustained virological response, essentially a functional cure that means the virus is eliminated and prevented from replicating.
The best responses were seen when the new pill was taken alongside the antiviral drug ribavirin, which is already commonly used to treat hepatitis C.
Patients who had failed to respond to other treatments reacted as well or better than those who had previously been treated successfully, or not treated before.
Prof Eric Lawitz, from the University of Texas, who led the study reported online in The Lancet journal, said: “To our knowledge, this trial is the first to report data for cirrhotic genotype 1 hepatitis C patients who did not respond to prior treatment with a protease inhibitor regimen, a population without treatment options at present.
“The results of this trial suggest that the fixed-dose combination of sofosbuvir and ledipasvir could offer patients a short, all-oral treatment that might be highly effective and safe in patients who tend not to respond well to existing therapies, including individuals with cirrhosis, or black race, resistant strains of the virus, and those who have not responded to standard-of-care regimens that include protease inhibitors.”
Side-effects included nausea, anaemia, respiratory tract infection, and headache, but these were not considered serious.
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