5th International Workshop on Hepatitis C

http://natap.org/
_______________________________________________
from jules: I just returned from 3 days in Boston at the HCV Pharmacology & Resistance in New HCV Compounds Workshop. There was quite a lot of controversy about how drug resistance will look related to the new oral HCV drugs, the key question being when patients fail will mutations prevent response to future use of the same class of drugs or in fact reusing the same drug. For people familiar with HIV drug resistance this statement may sound strange because in HIV mutations once developed persist forever and prevent use of the same class of drugs except of course until effective drugs were developed that specifically were developed to suppress resistant virus like for example darunavir & kaletra. But in HCV it appears now that it may be different but we do not know yet exactly what will develop so there is a lot of controversy. For example if a patient fails an HCV protease inhibitor & mutations develop will these mutations prevent a response to another protease inhibitor or the same one used 3 years later after perhaps the mutations fade, because some researchers say these mutations are not archived like in HIV. We do not know what will happen & this is an important question. Nonetheless in 2011 it is expected that 2 HCV orally administered protease inhibitors will be FDA approved to be used in triple drug combination therapy each one separately with peginterferon plus ribavirin. Behind this a re another 20+ orally administered HCV drugs, which are expected to be equally effective in whits & african-americans, in treatment-naives and treatment-experienced, except of course the background therapy of peg/rbv will not be as effective in treatment-experienced prior nonresponders and this is a very important point to bear in mind in deciding when to begin therapy as in the future standard of care therapy is expected to be 2, 3 or 4 oral drugs in combination with or without peg/rbv which offer to everyone in the USA the opportunity to be cured, unless of course if a patient's HCV disease is so far progressed they are too sick to take the medications. Here are initial reports from the conference and more reports will be forthcoming.

5th International Workshop on Hepatitis C
Resistance and New Compounds
24-25 June 2010, Boston, MA USA

Ch ronic HCV Infection: How Does Maturation of the HCV Infected Patient Population Impact Drug Development - Gary Davis MD - (06/25/10)

Aging of Hepatitis C Virus (HCV)-Infected Persons in the United States: A Multiple Cohort Model of HCV Prevalence and Disease Progression
Gastroenterology Feb 2010
HCC in persons older than the age of 65 years with HCV infection has doubled during the last several years....
Currently, only a small proportion of those with CH-C are aware of their infection and, of these, just 10% to 27% are offered treatment.....
the proportion of cases with advanced fibrosis will continue to rise during the next 2 decades (Cirrhosis accounted for just 5% of all cases (diagnosed and undiagnosed) of CH-C in 1989, 10% in 1998, and 20% in 2006, the proportion with c irrhosis is projected to reach 24.8% in 2010, 37.2% in 2020, and 44.9% in 2030).....
critical to identify infected persons and treat their disease before advanced fibrosis or liver failure ensues

1. Aging of Hepatitis C Virus (HCV)-Infected Persons in the United States: A Multiple Cohort Model of HCV Prevalence and Disease Progression - (03/11/10)


Implications of host polymorphism IL28b for drug development and patient care - Mark Sulkowski MD - (06/25/10)

1. Amino acid substitution in HCV core region and genetic variation ne ar IL28B gene predict viral response to telaprevir with peginterferon and ribavirin - (05/03/10)
Hepatology - Accepted Preprint
26 Mar 2010
According to the genetic variation in rs12979860, sustained virological response was achieved by 83.8% (31 of 37 patients), 34.5% (10 of 29 patients), and 0% (0 of 2 patients), in patients with genotype CC, CT, and TT, respectively. Thus, a significantly higher proportion of patients with genotype CC (83.8%) showed sustained virological response than that of patients who showed genotype non-CC (32.3%) (Figure 2, P<0.0 01) (Table 2).

1. Hepatitis C Treatment in an Urban Population -
SVR rate for genotype 1 hispanics in this study is 11% and 30% for genotype 2 and 14% for African-Americans with genotype 1




The 5th International Workshop on
Clinical Pharmacology of Hepatitis Therapy
Boston, MA June 23-24, 2010



* Regulatory Requirements for Early Clinical Testing of Novel HCV Antiviral Drugs: FDA Perspective, Jeff Murray, M.D., M.P.H. FDA, Division of Antiviral Products - (06/25/10)

* A European Perspective: EMA and his critical standpoint, Prof. Jean-Michel Pawlotsky, MD, PhD - (06/23/10)