IU Researcher Publishes Landmark Results for Curing Hepatitis C in Transplant Patients

Article

A new treatment regimen for hepatitis C, the most common cause of liver cancer and transplantation, has produced results that will transform treatment protocols for transplant patients, according to research published online today in the New England Journal of Medicine.

The investigational three-drug regimen, which produced hepatitis C cure rates of 97 percent, is an oral interferon-free therapy. Previously, the typical treatment for hepatitis C after a liver transplant was an interferon-based therapy, usually given for 48 weeks. It had a much lower response rate, had a risk of organ rejection and was poorly tolerated because of the immunosuppressants required to prevent rejection. The new oral regimen -- ABT-450, ombitasvir and dasabuvir (with or without ribavirin) -- produces significantly fewer side effects and is prescribed for 24 weeks.

First author Paul Kwo, MD, professor of medicine at the Indiana University School of Medicine, called the results of the international clinical study a "landmark achievement."

Kwo, who is medical director of liver transplantation at the IU School of Medicine and IU Health, said that cirrhosis caused by hepatitis C is the leading reason for liver transplantation in the U.S., and those patients have lower survival rates than patients transplanted for other causes of cirrhosis.

Patients with hepatitis C who receive a liver transplant have a 20 to 30 percent chance of developing recurrent cirrhosis within five years after transplant. Hepatitis C, which is usually asymptomatic until severe liver damage occurs, is transmitted by exposure to contaminated blood. The most common way to get hepatitis C is through intravenous drug use, with the Centers for Disease Control and Prevention estimating that 3.2 million individuals in the United States have contracted the hepatitis C virus.

In 2013, 6,400 liver transplants were performed in the U.S., according to the Organ Procurement and Transplantation Network, and nearly 50 percent of those patients had hepatitis C with or without liver cancer.

The phase 2, multi-center trial enrolled 34 liver transplant recipients with hepatitis C who did not have cirrhosis. Of those, 33 patients or 97 percent exhibited no sign of hepatitis C virus at 24 weeks after treatment with the new drug regimen, and none suffered transplant rejection. In a similar phase 3 trial of non-transplant patients with cirrhosis, a historically difficult patient group to treat, the same treatment regimen produced a 96 percent cure rate for hepatitis C.

"Recurrent hepatitis C post liver transplantation has historically been difficult to treat, and we have considered post-liver-transplant patients a special population in need of new treatment strategies," Kwo says. "What this study showed is that this special population is no longer special. We can treat them as successfully as if they haven't had a liver transplant with drugs that are well tolerated and without risk of rejection."

This international research study was funded by AbbVie. The results from this study and a phase 3, multi-center randomized study was presented Nov. 11 at the 2014 the American Association for the Study of Liver Disease annual meeting in Boston.

Source: Indiana University 



 

Recent Videos
Pathogen Playbook Presenter: Sharon Ward-Fore, BS, MS, MT(ASCP), CIC, FAPIC
Mark Wiencek, PhD
Rebecca Crapanzano-Sigafoos, DrPH, CIC, AL-CIP, FAPIC
The CDC’s updated hospital respiratory reporting requirement has added new layers of responsibility for infection preventionists. Karen Jones, MPH, RN, CIC, FAPIC, clinical program manager at Wolters Kluwer, breaks down what it means and how IPs can adapt.
Studying for the CIC using a digital tablet and computer (Adobe Stock 335828989 by NIKCOA)
Infection Control Today's Conversations with the HSPA President, Arlene Bush, CRCST, CER, CIS, SME, DSMD, CRMST
Infection Control Today's Conversations with the HSPA President, Arlene Bush, CRCST, CER, CIS, SME, DSMD, CRMST
Cheron Rojo, BS, FCS, CHL,  CER, CFER, CRCST
Matthias Tschoerner, Dr Sc
Standardizing Cleaning and Disinfection
Related Content