Are There Shades of Grey in Hepatitis C Treatment Success?
It is easy to think of treating an illness in black or white terms – defined as cured or not cured. However, there may be shades of grey in-between these extremes. A large study conducted at the University of Washington in Seattle has found that interpreting a Hepatitis C treatment outcome may not be cut and dry.
Successful Hepatitis C Treatment Definition
Affecting an estimated 4 to 5 million Americans, Hepatitis C is a major public health problem. Because those with this virus are typically asymptomatic for several years, it is often not detected until the illness is in the late stages. Hepatitis C that has progressed to advanced liver disease can have serious consequences such as cirrhosis, liver cancer and liver failure.
Since Hepatitis C was categorized in the early 90s, getting rid of this tenacious liver viral infection has proved to be a monumental challenge. The current triple-drug treatment regimen boasts a 75 percent success rate, which means that three-quarters of patients who take the drugs will have an undetectable viral load six months after treatment completion. Clinicians dub this desired outcome as sustained viral response, abbreviated as SVR. For those who are not able to “eliminate” the virus from their body, managing Hepatitis C is crucial to prevent a worsening of their liver’s condition.
People who do not achieve SVR are commonly referred to as treatment non-responders. Although eliminating the virus in everyone is ideal, this perspective is very black and white; individuals who have achieved SVR are successful and non-responders have failed.
Shades of Grey
Practitioners and patients rarely give Hepatitis C treatment outcomes between successes and failures much consideration. However, research led by Chihiro Morishima, MD at the University of Washington in Seattle broadens the spectrum of successful Hepatitis C treatment. This study demonstrates that profound suppression of the Hepatitis C virus reduces events that cause advanced liver disease – even in those who do not achieve SVR.
In this study, treatment non-responders had improvement in their liver health that correlated with the degree of Hepatitis C viral suppression achieved. More specifically, measurements for liver inflammation and liver scarring (as determined by liver enzyme levels and biopsy), improved in those who had viral suppression early in the treatment process – even if some viral particles resurfaced six months after treatment completion. The researchers found this to be true at one and a half and three and a half years following the end of Hepatitis C treatment. Compared to patients who did not have viral suppression early on, individuals with early viral suppression were significantly less likely to experience advanced liver disease – including liver cancer and death – over a six-year period.
This University of Washington finding gives hope to previous non-responders who achieved viral suppression early in their Hepatitis C drug treatment regimen. Thus, we can assume that if the medications suppressed the Hepatitis C virus at some point in treatment, all was not for naught. Achieving SVR is still the benchmark for successful Hepatitis C treatment. However, previous non-responders should know that there appears to be gradations of what renders Hepatitis C treatment beneficial.
http://www.bettertoknowc.com/pages/understanding-treatment-options, Understanding Treatment Options, Retrieved July 22, 2012, Vertex Pharmaceuticals, Inc., 2012.
http://www.ncbi.nlm.nih.gov/pubmed/22688849, Reduction in Hepatic Inflammation Is Associated With Less Fibrosis Progression and Fewer Clinical Outcomes in Advanced Hepatitis C, Morishima C, Retrieved July 22, 2012, American Journal of Gastroenterology, advanced online publication June 2012.
http://www.news-medical.net/news/20120619/HCV-suppression-reduces-liver-damage.aspx, HCV Suppression Reduces Liver Damage, Lynda Williams, Retrieved July 22, 2012, News-Medical.net, 2012.
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