New Approach to Hepatitis C Treatment Shows Promise in Expanding Access to Care
A groundbreaking study demonstrates that a significantly streamlined approach to hepatitis C virus (HCV) treatment – involving minimal monitoring and simplified medication delivery – is both safe and effective,perhaps revolutionizing access to care for those most in need. The findings, published in The Lancet Gastroenterology & Hepatology (2022), support a shift away from conventional, resource-intensive monitoring protocols and align with updated guidelines from leading medical organizations.
HCV disproportionately affects vulnerable populations, and barriers to consistent medical follow-up often hinder treatment completion. The ACTG A5360 [MINMON] trial, a phase 4, open-label, single-arm study, tackled this challenge by implementing a four-component strategy: eliminating pretreatment genotyping, dispensing the entire 12-week course of sofosbuvir and velpatasvir at study entry, removing scheduled visits and routine laboratory monitoring, and utilizing only two remote contacts – one at week 4 for adherence support and another at week 22 to schedule a week 24 sustained virologic response (SVR) assessment22. This minimal monitoring approach proved prosperous, demonstrating that the full HCV treatment course can be safely delivered and completed without on-treatment monitoring.
The study’s results have prompted updates to treatment recommendations from both the American Association for the Study of the Liver and the European Association for the Study of the Liver (EASL)7, 22, 23. These updated guidelines, alongside the collaborative efforts of industry, academic, community, and nonprofit researchers, signal a important step towards closing the gap in HCV care and achieving widespread viral elimination. The American Association for the study of Liver Diseases now recommends this approach for monitoring patients starting, on, or completing HCV therapy (accessed July 2023)23.
