Amazing victory! Three weeks to overcome hepatitis C is not a dream, can it be applied to the world to be observed?
Release date: 2015-11-17
In the battle against hepatitis C virus (HCV) drugs that damage the liver, an astonishing victory is likely to emerge: a small study shows that it is possible to cure some infected people in at least 3 weeks.
Recently, four new HCV drug combinations that cleared many different types of viral infections in about three months were approved. This was followed by a team led by George Lau, a human and healthy gastrointestinal and liver center hepatologist in Hong Kong, China, who mixed and matched the various compounds to see if they could further shorten the treatment path. After 3 weeks of treatment, 18 HCV-infected individuals who took 3 different combinations of drugs met the standard definition of cure - after 12 weeks of treatment, their blood did not show HCV genetic material RNA in the standard test. Signs. The researchers plan to present the data publicly for the first time at an academic conference at the Liver Congress.
Before the emergence of new HCV drugs, infected people need to receive 8 months of treatment. However, treatment often fails and produces serious side effects. Today, standard treatments require only 12 weeks of HCV medication. Shyam Kottilil, an HCV researcher at the Institute of Human Virology in Maryland, said that it would be "very attractive" to shorten this treatment time. If the research results are valid, it will significantly reduce the total cost of $100,000 needed for the most popular drugs for 12-week treatment. Kottilil's own 4-week treatment study—different combinations of drugs have been tested in different patient populations, with only 40% cure out of 50 participants.
Other researchers have raised warnings about a three-week cure, the most important of which is that the 18 people who are treated have some of the characteristics of patients who respond well to HCV. "It's fun, but it's not unexpected," said David Nelson, a researcher at the University of Florida.
Raymond Schinazi, a biochemist at Emory University in Atlanta, who works with Lau, acknowledges that this is only a preliminary study and needs to be validated in larger clinical trials. “However, when you reach a 100% cure rate, it is statistically significant.†Schinazi helped develop a new anti-HCV bestselling drug, sofosbuvir, which is the latest Part of the drug combination tried in the study.
Prior to May 2011, the only approved drug for HCV worked through non-specific antiviral drugs and immune mechanisms, but its side effects were obvious and failed 40% of the time. Since then, 12 so-called direct-acting antiviral drugs have entered the market – all drugs are expensive, and many promising similar drug candidates are in development.
The study tested three different triple therapies consisting of the most effective direct-acting antiviral drugs, each targeting a different HCV enzyme or protein that is critical for viral replication. Sofosbuvir targets the RNA polymerase of HCV and is the backbone of all three protocols. It is widely regarded as the top drug in the field of HCV treatment, has a relatively high efficacy, has few side effects, and is rarely blocked by mutations in resistant drugs. (The initial retail price of sofosbuvir is $1,000 per piece, which is controversial internationally.) Researchers have combined it with Radiparvir or Dakavirvir, which can damage the viral proteins known as NS5a. Combine. To complete this cocktail therapy, the researchers selected one of two HCV protease inhibitors, ciprovir or anapyvir.
These drugs are produced by three different large pharmaceutical companies. Schinazi asserts that in order to protect the market, they will resist cooperation with each other. “I want to confirm to these companies that they should have been conducting this research long before.†Schinazi helped pay for the drugs used in the study. “When you combine the best medicines, you will of course get incredible results.â€
In order to obtain these results, the researchers purposefully searched for "the fruit hanging at the bottom" and Hong Kong was an ideal test site. HCV has six different genotypes, the latter being divided into various subtypes. In China, the most popular type is the 1b genotype, which is more likely to respond to drug treatment than any other genotype. Previous studies have shown that 8 weeks of sofosbuvir and redipavir treatment can cure almost every patient. Large studies have also found that 84% of Chinese HCV patients have a variant of the immune gene (known academically as IL28b cc). It provides a strong spontaneous attack against the virus, providing an advantage for Chinese patients in receiving effective treatment.
However, Nelson said the study "confirmed the idea well," but he wondered whether the three-week treatment would be suitable for global response to HCV. Although it is estimated that 1 genotype accounts for about 46% of all infected people worldwide, most Americans have a more difficult type 1a to treat. About 22% of infected people worldwide have 3 genotypes, and it is also more difficult to cure than 1b. According to Nelson, under ideal conditions, a standard treatment regimen should work against all genotypes without having to test the initial response or the state of cirrhosis.
Source: Chinese Journal of Science
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