The cost of treating hepatitis C virus (HCV) could be cut up to 50 per cent if mathematical models are used to predict when patients can safely stop taking medication, according to a new study.
An estimated 170 million people have the blood-borne infection worldwide, which is a major cause of chronic liver disease, researchers said.
The recent approval of direct-acting antiviral (DAA) has led to a revolution in the treatment of HCV, but the high cost of DAAs limits access to treatment in US and abroad, they said.
"Recent clinical trials of DAAs against HCV suggest that cure of the infection often took place before the end of treatment," said Harel Dahari, assistant professor at Loyola University Chicago Stritch School of Medicine.
"Treatment currently is standardised to be given for a set period of time, not tailored to the patient," said Scott Cotler, hepatology division director for Loyola.
"In many cases, this may result in the prolonged use of expensive drugs with essentially no additional positive effect," said Dahari.
Using more frequent blood testing to determine HCV levels, researchers were able to identify when a cure was reached and predict when therapy could be discontinued.
This modelling could allow for individualised treatment to achieve optimal results while reducing drug duration and cost.
"This is the first time this approach has been tested in hepatitis C patients undergoing DAA treatment. This initial study is very encouraging," Dahari said.
Researchers examined the test results of 58 chronic-HCV patients being treated with the widely used DAA drug sofosbuvir, combined with daclatasvir, simeprevir or ledipasvir, in three French referral centres.
HCV was measured before treatment (called baseline), at day two, every other week, end of treatment and then 12 weeks after end of treatment. Mathematical modelling was used to predict the duration of treatment need to achieve a cure.
"The use of early viral-kinetic analysis has the potential to individualise duration of DAA therapy with a projected cost savings of 16 to 20 per cent per 100 treated persons and up to 50 per cent in about 40 per cent of patients," researchers said.
"Shorter regimens with low pill burdens, and few adverse effects, could improve patient adherence in difficult to treat populations," they said.
