Patients infected by hepatitis C virus (HCV) can be cured within 3 weeks of therapy using an NS3 protease inhibitor and dual NS5A inhibitor–NS5B nucleotide analogue – the so called ‘direct acting antivirals (DAA)’! See the work published very recently:
- Efficacy and safety of 3-week response-guided triple direct-acting antiviral therapy for chronic hepatitis C infection: a phase 2, open-label, proof-of-concept study [Link]
We’ve been involved to use a nonlinear mixed effect modeling approach to analyze the viral kinetic data to show that the DAA combinations used in this study are highly effective at blocking viral RNA synthesis, replication and assembly.
One caveat of the study is the sample size – although 100% of patients who are treated with 3-week DAA therapies are cured of HCV, the total sample size is 18, and all participants are Asian. It is not clear how these results scale to a larger population or populations of other ethnicities.
HCV infects approximately 150-180 million people (3% of total population). The development of direct acting antivirals against HCV has enjoyed remarkable successes recently – it changed the HCV treatment from interferon therapy which lasts 48-week long with severe side effects and low cure rates to 8-week, 6-week and now possibly 3-week DAA therapies with little side effects and extremely high cure rates (>90%). Sounds great, doesn’t it?