Shorter HCV Regimen Effective in Black Patients

Black patients may be eligible for a shorter course of hepatitis C virus treatment.

A shorter, 8-week antiviral treatment regimen for black patients with hepatitis C virus (HCV) may be an effective alternative to the standard 12-week schedule, according to a new study published by Clinical Gastroenterology and Hepatology.

The study suggests that this patient group may be able to achieve the same outcomes with a shorter course of therapy, thus, saving money.

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"Our findings do not support current hepatitis C treatment guidelines that recommend against the use of a shorter course of treatment in black patients," said lead author Julia L. Marcus, PhD, MPH.

Current treatment guidelines indicate that black patients should receive a 12-week course of ledipasvir/sofosbuvir, even if they meet the criteria for the 8-week regimen, according to the authors.

The recommendation developed by the American Association for the Study of Liver Diseases and Infectious Diseases Society of America was based on previous studies that suggested a shorter course of therapy may not be effective for this population; however, the research did not compare the efficacy of the regimens in black patients eligible for 8-weeks of therapy, according to the authors.

Included in the new study were more than 2600 patients with HCV treated with ledipasvir/sofosbuvir. The goal was to determine whether black patients could achieve a sustained viral response on a shorter course of antivirals.

The efficacy of an 8- or 12-week schedule of ledipasvir/sofosbuvir was more than 95% in a majority of subgroups, including black patients, according to the study.

These results suggest that physicians should prescribe an 8-week regimen for black patients who meet additional eligibility criteria.

Not only can a shorter treatment period lessen adverse events, but it can also benefit providers, health care systems, and payers, according to the study. Shorter treatment duration may also encourage patients to remain adherent to the antivirals.

"We found that treatment was equally effective for black patients who were treated for 8 and 12 weeks," said senior author Michael J. Silverberg, PhD, MPH. "The 8-week regimen was also generally underused for all patients, with 26% of those eligible for eight weeks receiving 12 weeks of therapy."