New Hepatitis C Treatment Regimen a Landmark for Transplant Patients

Three-drug regimen will lead to new treatment protocols for transplant patients, study finds.

A breakthrough in treating hepatitis C in liver transplant patients will transform treatment protocols in the future, according to the results of a new study.

In the past, a typical treatment for hepatitis C following a liver transplant involved an interferon-based therapy for a duration of 48 weeks. This treatment produced a significantly lower response rate, carried a risk of organ rejection, and was poorly tolerated due to immunosuppressants that prevented rejection.

Published online November 11, 2014 in the New England Journal of Medicine, researchers evaluated an investigational oral interferon-free 3-drug regimen of ABT-450, ombitasvir, and dasabuvir (with or without ribavirin).

The 3-drug oral regimen was found to generate significantly fewer side effects over a shorter duration of 24 weeks. The study’s first author Paul Kwo, MD, labeled the results of the international clinical study a landmark achievement.

"Recurrent hepatitis C post liver transplantation has historically been difficult to treat, and we have considered post-liver-transplant patients a special population in need of new treatment strategies," Dr. Kwo said in a press release. "What this study showed is that this special population is no longer special. We can treat them as successfully as if they haven't had a liver transplant with drugs that are well tolerated and without risk of rejection."

Hepatitis C patients who receive a liver transplant carry a 20 to 30% chance of developing recurrent cirrhosis within 5 years following the procedure.

In a phase 2 multi-center trial, 34 liver transplant recipients with hepatitis C who did not have cirrhosis were enrolled. A total of 33 patients (97%) exhibited no sign of hepatitis C at 24 weeks after being treated with the 3-drug regimen, and none had their transplant rejected.

During a similar phase 3 trial involving non-transplant patients with cirrhosis, the same 3-drug regimen produced a 96% cure rate for hepatitis C.