Jim Kling

August 28, 2013

DENVER — New therapeutic regimens are in the works to permanently curb many hepatitis C infections. Delegates attending the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) will be privy to the latest, cutting-edge information.

Dr. Robin Patel

"There will be a symposium on what every infectious disease physician should know about treating hepatitis C," Robin Patel, MD, vice chair of the ICAAC program committee, told Medscape Medical News.

Current hepatitis C therapy consists of a protease inhibitor, pegylated interferon, and ribavirin, but the adverse effects of flu-like symptoms and anemia are poorly tolerated by some patients and disqualify others because of comorbidities. "Response rates are very good, but we are limited in who we can treat because of side effects and required length of therapy," explained session comoderator Kimberly Brown, MD, chief of gastroenterology and hepatology at the Henry Ford Hospital in Detroit, Michigan.

New therapies are shorter in duration and eliminate interferon but still lead to high cure rates. New therapies will be administered orally and target hepatitis C genotypes 2 and 3; genotype 1 will be treated with an oral agent, interferon, and ribavirin, but for a shorter period of time. The new regimens should have a higher cure rate than the current regimen, and be applicable to a wider patient population, according to Dr. Brown.

More Cures

The developments are good news for patients. "Cures have been associated with improved liver histology, better liver function, reduced rates of liver cancer, and overall improved survival," said Dr. Brown. "Patients who have previously not been candidates for treatment because of their other medical conditions are looking forward to access to therapies they can tolerate."

The new drugs and regimens have been in development for years, but they are coming to the market more rapidly now because the shorter treatment duration makes it possible to test them more quickly for safety and efficacy.

 
This is really a huge change in clinical practice.
 

"This is really a huge change in clinical practice," said Dr. Patel.

The ICAAC, which runs from September 9 to 13, will host delegates from 80 different countries. Of the 5000 people expected to attend, about 3000 will be from outside the United States.

"Over the years, the ICAAC has become a very international meeting," said Dr. Patel. "There are people literally from everywhere around the globe. I always learn so much from all the attendees, but especially the international attendees. I think our big international presence is a bit different from other meetings."

Because infections spread from country to country and continent to continent, it is important to stay up to date on current research, pointed out Dr. Patel, who is professor of medicine and microbiology at the Mayo Clinic in Rochester, Minnesota. A microbial agent that is currently absent in the United States could arrive any time, she cautioned.

The meeting will feature plenaries, oral sessions, and posters. In all, more than 1500 abstracts will be presented. Studies will outline which treatment regimens have been modified so that existing drugs can be applied to novel infectious agents.

Pharmacology will have a big presence at the meeting. "You can come up with new ways of giving an old drug that will make it work better or will work against organisms that we didn't traditionally think it would work against, " said Dr. Patel. "This can include a novel way of administering the drug — for instance, using prolonged infusion."

Updates on novel vaccines and vaccine trials will cover various disease organisms, including some with no current vaccines, such as tuberculosis.

There will be a keynote lecture on the future of antimicrobial therapies by Fernando Baquero, MD, from Ramón y Cajal Institute for Health Research in Madrid, Spain. There will also be a lecture on the importance of innovation in the treatment of infectious diseases in developing countries by Trevor Mundel, MD, president of global health at the Bill and Melinda Gates Foundation.

In a special session on Escherichia coli, James Johnson, MD, professor of medicine at the University of Minnesota in Minneapolis, will describe 3 pathotypes of E coli and changes in E coli populations that can lead to increased virulence and antimicrobial resistance.

The ICAAC will have an extensive online presence. Six sessions will be streamed live and, after the meeting, more than 125 sessions will be available online.

For entertainment, conference organizers will host a game show. Infectious disease experts from around the world will be pitted against one another to answer trivia questions. In addition to fun, the show will provide "interesting and educational pieces about infectious diseases," Dr. Patel noted.

Dr. Patel reports receiving research support from Pocared, Pradama, Tornier, Pfizer, Astellas, Biofire, and 3M; serving as a consultant to Thermo Fisher; and having patents on a Bordetella pertussis/parapertussis PCR assay, an antibiofilm substance, and a method and device for sampling biofilms on the surfaces of removed implants. Dr. Brown reports being a consultant for Janssen, Merck, Vertex, Gilead, Salix, and Genentech; being on the speakers' bureau for Gilead; and receiving research support from Merck, Gilead, Mass Biologics, Vertex, and Eisai.

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