Antiviral Drugs Could Cut Hepatitis C Prevalence by 80 Percent

Enhanced screening and treatment in high-risk populations could eliminate virus.

The arrival of highly effective antiviral hepatitis C virus (HCV) drugs could eventually work with other factors to eradicate the virus, a recent study suggests.

Published online in Clinical Infectious Diseases, the study found the prevalence of blood-borne HCV infection could be reduced by more than 80%, according to researchers from Yale. The researchers note that if factors such as if enhanced screening and treatment efforts among high-risk populations are put in place, the prevalence of HCV could be greatly reduced or eliminated altogether.

Direct-acting antiviral medications, including Harvoni and Sovaldi, have shown cure rates greater than 90%. The researchers suggest 2 methods to reduce or eliminate the virus: treatment that prevents HCV-related complications and deaths, and preventing transmission among injection-drug users.

The researchers developed a transmission model that predicts the long-term treatment effect of direct-acting antivirals at both current and enhanced screening and treatment rates. The researchers also evaluated outcomes such as cirrhosis, liver transplants, and mortality, the study noted.

"The key finding is that a 4-fold increase to the number of patients treated each year could virtually eliminate HCV from the non-injecting population within a decade," said senior author Jeffrey Townsend, associate professor of public health.

Even moderate screening and treatment gains could significantly decrease new infections and mortality, the authors found. Among high-risk injection drug users, researchers found expanded screening and treatment alone would not sufficiently reduce HCV prevalence.

"In order to completely eliminate HCV, efforts to access that community are extremely important," said lead author David Durham.

However, a combination of enhanced screening and treatment, new direct acting antivirals, and targeted behavioral interventions that include needle-exchange programs or opioid substitution therapy could go a long way in reducing HCV prevalence.

"We should be very optimistic about the prospect of eliminating HCV as a disease within the US using these direct acting antivirals, especially if they are combined with targeted behavioral interventions to reduce transmission," Townsend said.

Townsend added, "due to the currently high cost of these treatments, as a society we need to think carefully about how to make that happen."