Fight AIDS Foundation

In 2011, new drugs against Hepatitis C virus, as Telaprevir and Boceprevir, were approved, offering new cure opportunities for infected patients. These new and more efficient drugs are the so-called direct-acting antiviral drugs against hepatitis C virus. Importantly, in the last months, a new generation of direct-acting antiviral drugs appeared: Sofosbuvir, Daclatasvir and Simeprevir. They are more potent and show a higher level of success to cure Hepatitis C virus infection.

Recently, researchers from the Institute for AIDS Research IrsiCaixa and the Fight Against AIDS Foundation have documented for the first time worldwide the sexual transmission of a variant of the hepatitis C virus that is resistant to direct-acting antiviral drugs. The article, published in the journal Gastroenterology on July 25, describes a case observed at the HIV Unit of the Germans Trias Hospital, where IrsiCaixa and the Fight Against Foundation are located.

The transmission of Hepatitis C virus resistant to these new drugs from one patient to another diminishes their capacity of curing hepatitis C virus infection, lengthens the duration of the treatment and, what is more important, affects quality of life of patients with a higher probability of health complications. As the IrsiCaixa researcher Miguel Angel Martínez, co-coordinator of the study, says, “this leads to a decrease of the cost-efficiency of these new drugs, to higher expenses for the health system, and therefore it can be an important clinical and public health problem”.

The study has documented a case of re-infection by sexual transmission of a resistant variant of hepatitis C virus from a patient (A) to his partner (B). Both men are co-infected with HIV, and had previously been exposed to the new treatments through different clinical trials to treat hepatitis C virus infection. Patient B was cured, but the current study demonstrates that patient A, which was not cured, developed drug-resistant viruses, which were then transmitted to his partner B.

this case history strongly underlines that “successful treatment of hepatitis C virus does not preclude re-infection and therefore emphasizes the need for behavioral and prevention interventions in patients at increased risk for re-infection”, as explains the physician and researcher at FLS Cristina Tural, co- coordinator of the study.

According to the World Health Organization (WHO) about 3% of the worldwide population is affected by Hepatitis C infection. The WHO also estimates that 4 million people contract hepatitis C virus each year. This epidemic currently affects a growing proportion of HIV-positive men who have sex with men in Europe. This represents probably one of the main sources of new hepatitis C virus infections in developed countries. For this reason, this is a priority line of research for IrsiCaixa and FLS as part of their comprehensive fight against AIDS.

Abstract and full text online.