How Long Should HCV Patients Be Treated? Study Explains

Model of Hepatitis C

What is Hepatitis C virus (HCV)?

Hepatitis C virus (HCV) is a type of blood-borne virus that can bring about acute and chronic liver changes. During the first stages of the infection, the patient may show no signs and symptoms; during these early stages, the disease may not be life-threatening. About 15“45% of infected persons spontaneously clear the virus within 6 months of infection without any treatment. However, in about 55 to 85% of patients, there would be chronic HIV infection which can later on lead to cirrhosis of the liver within 20 years. Cirrhosis of the liver is life-threatening.

The hepatitis C virus can be transmitted through the blood. It can be transmitted to other persons through injections and sharing of needles, through health care settings due to the reuse or inadequate sterilization of syringes and needles, through transfusion of unscreened blood and blood products, through sexual contact or through maternal to baby transmission.

Hepatitis C virus (HCV) infection has an incubation period of 2 weeks to 6 months. After initial infection, about 80% of patients do not exhibit symptoms. However, signs and symptoms may surface out such as fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured faeces, joint pain and jaundice (yellowing of skin and the whites of the eyes). The infection can be diagnosed using laboratory tests. Screening for anti-HCV antibodies with a serological test may be done to identify people who may be infected with the virus. If this test is positive, a nucleic acid test for HCV RNA is needed to confirm chronic HCV infection. It is said that about half of the patients who are infected with HCV can spontaneously clear the infection through strengthening the immune response without treatment. These patients will still test positive for anti-HCV antibodies.

After long-term hepatitis infection, there may be liver damage (fibrosis and cirrhosis). The presence of this may be assessed done by liver biopsy or through a variety of non-invasive tests. The genotype of the hepatitis C strain must be identified because there are about 6 genotypes of the HCV and they respond differently to treatment. It is possible to be infected with more than one genotype.

Screening is recommended for people who may be at high risk for infection, such as people who inject drugs, recipients of infected blood products or invasive procedures in health-care facilities with inadequate infection control practices, children born to mothers infected with HCV, people with sexual partners who are HCV-infected, people with HIV infection, people who have used intranasal drugs and people who have had tattoos or piercings.

How Long Should HCV Patients Be Treated?

A recent study published in the journal Hepatology is the first to report real-time tracking of viral decay in the liver and blood in 15 patients with HCV. This study, done by researchers from University at Buffalo, is the first to trace in real-time how the drug telaprevir inhibits viral replication in the liver and how it clears HCV from infected cells and plasma of infected patients. The study was sponsored by Vertex Pharmaceuticals, which makes telaprevir, an HCV protease inhibitor.

In the study, conducted at Weill Cornell Medical College in New York City, 15 patients with chronic HCV infection were treated with telaprevir-based triple therapy (consisting of telaprevir/pegylated interferon alfa/ribavirin), an HCV treatment regimen that was approved by the Food and Drug Administration in 2011. The authors found that HCV RNA decay in the liver lagged behind that in the peripheral blood, which has implications for how long the virus may persist in the body and the possible duration of treatment needed.

More medical breakthroughs are featured in our other articles.