Compensating for the effects of interferon will help some patients with HCV, but a different approach may be needed for others. A pair of studies recently published in the New England Journal of Medicine indicate that interferon-free therapies for HCV infection might be on the horizon.

The first study demonstrated that sofosbuvir and ribivirin may effectively treat HCV in patients with genotype 1, 2, or 3 infections. In that study, 40 previously untreated patients with HCV genotype 2 or 3 infection were randomly assigned to four groups. All received sofosbuvir and ribavirin for 12 weeks and three of the groups also received peginterferon for four, eight or 12 weeks. All 40 achieved sustained virologic response at 24 weeks. ³

The same study included two other groups of 10 treatment-naïve patients with HCV genotype 2 or 3 infection. One group of 10 received sofosbuvir and ribavirin for 8 weeks, while the other group received only sofosbuvir for 12 weeks. All of those who took sofosbuvir and ribavirin achieved SVR at 24 weeks, as did 60% of those on the monotherapy. In addition, in a group of 35 patients with HCV genotype 1 infection put on sofosbuvir and ribavirin, 84% of those who had never been treated achieved SVR as did 10% of those who had not responded to previous therapy.

The second study indicates that 12 weeks of therapy with ABT-450, a protease inhibitor; a nonnucleoside polymerase inhibitor, and ribavirin may effectively treat HCV genotype 1. Researchers tested various doses of the medications in patients who had not been treated previously as well as those who had not responded to standard therapy. More than 93% of patients in both groups achieved SVR.⁴

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2 Louie KS, Micallef JM, Pimenta JM, Forssen UM. Prevalence of thrombocytopenia among patients with chronic hepatitis C: a systematic review. J Viral Hepat. 2011 Jan;18(1):1-7.

3 Gane EJ, Stedman CA, Hyland RH, Ding X, Svarovskaia E, et al. Nucleotide polymerase inhibitor sofosbuvir plus ribavirin for hepatitis C. N Engl J Med. 2013 Jan 3;368(1):34-44.

4 Poordad F, Lawitz E, Kowdley KV, Cohen DE, Podsadeck T, et al. Exploratory study of oral combination antiviral therapy for hepatitis C. N Engl J Med. 2013 Jan3;368(1):45-53.