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CTAC's Report Back on the 2014 Special Conference on Hepatitis C

CTAC's Report Back on the 2014 Special Conference on Hepatitis C

september 25, 2014

By: Adam Cook, CTAC Policy Researcher

On September 11th, 2014, the American Association for Studies in Liver Disease (AASLD) in conjunction with the European Association for Studies of the Liver (EASL) hosted its 2014 Special Conference on Hepatitis C in New York City, NY. This conference was designed to allow researchers, medical professionals, and civil society stakeholders to meet and discuss the robust and vibrant treatment landscape that is changing how we treat hepatitis C. This special conference had been planned since the 2012 AASLD/EASL Conference on Hepatitis C in Prague, Czech Republic, and has been anxiously anticipated for the last 2 years. With over 25 speakers and hundreds of attendees representing over 35 countries, the 2-day conference allowed ample opportunity to discuss clinical trial results of new medications, post-market surveillance of existing medications, and the development of novel treatment options to cure hepatitis C (HCV).

The Canadian Treatment Action Council (CTAC) was represented at this special conference by Policy Researcher Adam Cook, as part of our continued commitment to monitoring treatment development and access to live-saving medications. The conference included many speakers applauding the veritable revolution in new Direct-Acting Antiviral HCV treatments that are fixed-dose, interferon-free, safe, tolerable, and able to cure the disease within 12-to-24 weeks. Evaluations of on-going trials and late-phase trial conclusions dominated most of the conference, with many new trials making exclusive or partial use of the very-effective sofosbuvir medication. While many trials are still focusing on pairing sofosbuvir with an additional antiviral, there is much work being done with newly-developed molecules that may even improve upon the sofosbuvir-standard.  Dr. Stefan Zeuzem of the University of Frankfurt discussed some new-molecule work being done to find a faster cure, for all genotypes, (many trials are looking at a 6 week cure; SVR6-12 at 96-99%) with or without sofosbuvir. 

While these new treatments look to become the norm in the future, many speakers also sought to frame the HCV epidemic in a present-day and global context. Dr. Brian Edlin from the Institute for Infectious Diseases persuaded that a global eradication initiative will depend on regular and coordinated screening, beginning with risk-based screening of Baby Boomers and developing into Birth Cohort Screening universally. Dr. John W. Ward of the US Center for Disease Control and Prevention urged caution and alerted the audience to the immediate need to re-think HCV epidemiology and vectors of transmission, away from the traditional populations concerned and recognizing increased infection rates among different populations such as people living with HIV/AIDs, Men who have Sex with Men (MSMs), and the rising population of suburban youth experimenting with opioids. Meanwhile, Toronto’s own Dr. Jordan Feld elaborated on his excellent work concerning the mechanisms of non-response to antiviral therapy in cirrhotic patients (considered the hardest-to-treat), and the viral reservoirs that may be the cause. From a global perspective, Hannover Medical School’s (Germany) Dr. Michael Manns prudently and correctly advised that a worldwide response to the hepatitis C epidemic will still include interferon-based therapies, and that revolutionary antivirals may not be the norm for low-to-middle-income countries for some time to come. Looking forward with eradication in mind, Ohio State University’s Dr. Christopher M. Walker, discussed the possibility of a preventative HCV vaccine.

The HCV epidemic is a global concern and accordingly, worldwide research and international data were enthusiastically presented by some of the world’s leading medical research bodies. Health Protection Scotland’s Prof. David Goldberg brought the domestic experiences of European nations to the audience, discussing similarities and differences in strategies, as well as what different health-science regulatory bodies can learn from one another. Prof. Goldberg was assisted in this task by Dr. Darius Moradpour from the University of Lausanne (Switzerland) and Dr. Jean-Michel Pawlotsky of the Universite Paris-Est (France).

While CTAC was concerned at the lack of discussion of economic barriers to access to many new treatments, we were encouraged to see that international consensus building, data-sharing, and eradication were premier topics among all speakers and attendees. The landscape of HCV treatment options is robust, vibrant, and dynamic, and CTAC is eager to continue its task of building the capacity of patients and stakeholders to navigate this exciting terrain while championing universal access to these life-saving medications.