Hepatitis C: Pilot Study Investigates Re-treatment After Relapse

MedicalResearch.com Interview with:
Anita Kohli, MS, MD

Clinician Investigator, Clinical Monitoring Research Program (CMRP)
Leidos Biomedical Research, Inc. formerly SAIC-Frederick, Inc.
National Institutes of Health Bethesda, MD 20892

Medical Research: What is the background for this study? What are the main findings?

Dr. Kohli: We previously treated 60 patients with sofosbuvir and ribavirin for 24 weeks. Patients who relapsed after treatment were offered re-treatment with another regimen of directly acting antivirals alone. 13 patients who relapsed were treated with sofosbuvir and ledipasvir for 12 weeks. All patients achieved SVR12. This is the first report of re-treating patients who failed a regimen including sofosbuvir with another regimen incorporating this same antiviral.

Medical Research: What should clinicians and patients take away from your report?

Dr. Kohli: Re-treatment of hepatitis C in patients who have failed previous DAA therapy is possible. However, resistance to hepatitis C drugs is an evolving story and seems like quite different than with HIV. It will continue to evolve with the introduction of new drugs and drug classes.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Kohli: While results of this study suggest that re-treatment with sofosbuvir containing regimens is possible, additional studies of failure after regimens that use other anti-virals is necessary. The impact of anti-viral resistance mutants on response to hepatitis C DAA only therapy is not understood.


Re-treatment of Chronic Hepatitis C Virus Genotype 1 Infection After Relapse: An Open-Label Pilot Study

Anu Osinusi, MD; Anita Kohli, MD; Miriam M. Marti, BS; Amy Nelson, RN; Xiaozhen Zhang, MS; Eric G. Meissner, MD, PhD; Rachel Silk, RN; Kerry Townsend, BA; Phillip S. Pang, MD, PhD; G. Mani Subramanian, MD, PhD; John G. McHutchison, MD; Anthony S. Fauci, MD; Henry Masur, MD; and Shyam Kottilil, MD, PhD

Ann Intern Med. 2014;161(9):634-638. doi:10.7326/M14-1211