Direct-acting antiviral therapies for the treatment of hepatitis C virus (HCV) could reduce prevalence by more than 80%, according to a study published online in Clinical Infectious Diseases.

David Durham, lead author of the study, and colleagues studied the effects of the new treatments on the U.S. population, the Yale team developed a transmission model to predict the effect of treatment with direct-acting antivirals over time. They also quantified the effect of use of the antivirals at current and at enhanced screening and treatment rates. Their analysis included outcomes such as cirrhosis, liver transplants, and mortality.

Yale’s researchers claim that HCV could be eliminated from the non-injecting public within a decade with the aid of advanced screening for high-risk individuals. Even modest increases in screenings could limit the number of new infections, according to the study researchers

However, the studies authors point out that users of injection-drugs are still the most at risk HCV group. A greater number of screenings alone among this group would not be enough to reduce the level of HCV infections. What is recommended for this group is an amalgamation of the new therapies with behavioral changes. This would include the use of needle exchanges programs or opioid substitution therapy.


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“To completely eliminate HCV, efforts to access that community [injection drug users] are extremely important,” said Durham. Jeffery Townsend, a senior author of the study added, “We should be very optimistic about the prospect of eliminating HCV as a disease within the U.S. using these direct acting antivirals, especially if they are combined with targeted behavioral interventions to reduce transmission.”

Reference

1. Durham D, Skrip LA, Bruce RD, et al. The impact of enhanced screening and treatment on hepatitis C in the United States. Clin Infect Dis.2015;doi: 10.1093/cid/civ894.