Hep B Cure Talks, Hep C Treatment Gaps Lead Conference

Laird Harrison

March 09, 2016

SAN FRANCISCO — The gap between hepatitis C drug trials and real-world clinical practice and the treatment of complications and comorbidities for patients with viral hepatitis will be among the highlights here at the International Conference on Viral Hepatitis (ICVH) 2016.

"It's not just a hepatitis C conference. It's hepatitis B and C," said meeting cochair Norah Terrault, MD, from the University of California, San Francisco. "In hepatitis B, there are exciting developments, with a functional immunological cure now being discussed," she told Medscape Medical News.

The meeting will also cover coexisting liver diseases, especially nonalcoholic fatty liver disease and how it fits into the treatment of viral hepatitis, Dr Terrault reported. And it will tackle complications, such as hepatocellular carcinoma, which affect many patients with viral hepatitis, despite the effectiveness of new treatments, she said.

The meeting is cosponsored by the University of California, San Francisco (UCSF), the International Association of Providers of AIDS Care (IAPAC), and the International Association for the Study of the Liver (IASL).

About 200 people are expected to attend, said Dr Terrault.

The keynote address, entitled After the Cure: Looking Ahead in HCV Management, will be delivered by Nancy Reau, MD, from the Rush University Medical Center in Chicago.

In hepatitis B, there are exciting developments, with a functional immunological cure now being discussed.

"A lot of my talk focuses on the more difficult-to-treat populations, some of the more marginalized groups, screening strategies, and prohibitive practices within payers," Dr Reau told Medscape Medical News.

Other presentations will look at the data gap between drug trials and clinical practice. In the past, drug makers focused their research on patients who were easiest to treat. But "that gap is closing as the trials have been more open to allowing individuals who are sicker and reflective of patients you might actually have in clinic," she explained.

Dr Reau will also present a study exploring whether the combination of interferon-free ledipasvir plus sofosbuvir is as effective in patients receiving opiate substitution therapy as in those not receiving such therapy.

"If you can get the person to take the drug, there's no reason to think that any of these special populations should have any less chance of clearing the virus," she said. "It's just a question of how you can do that safely and whether you retain the patient safely within the system."

Dr Reau said she is looking forward to a study by researchers from Brown University in Providence, Rhode Island, who have estimated how many people would need to be treated to eliminate hepatitis C in the state.

Other studies that will be presented will examine which therapies work best in patients with difficult-to-treat hepatitis C genotype 3, treatment regimens that last only 8 weeks, and protocols to screen for the infection.

Global Collaboration

During the conference, attendees will have the opportunity to consult with professionals from around the world about the practical challenges of treating patients with hepatitis B and C.

"This meeting has a more international perspective," said Dr Terrault. "By that I mean thinking globally about hepatitis B and C. We have chosen speakers who are representative of how the approach to the disease varies by country, and the specific challenges and the potential opportunities that may arise as a consequence."

Clinicians in the United States have benefited from the best access to powerful new therapies, but they can still learn from strategies developed in less wealthy countries, she said. "What we really learn from our global collaborators and partners and colleagues is how to do things more economically."

Among the international experts at the meeting will be Vicente Soriano, MD, PhD, from Hospital Carlos III in Madrid; Kosh Agarwal, MD, from King's College Hospital in London, United Kingdom; Ji-Dong Jia, MD, PhD, from Capital Medical University in Beijing; Karine Lacombe, MD, PhD, from St. Antoine Hospital in Paris; and Seng Gee Lim, MD, from the Yong Loo Lin School of Medicine in Singapore.

Panel discussions are designed to be interactive, so clinicians will get more of an opportunity to compare notes with experts than they would at other meetings, Dr Terrault said.

"Audience participation is encouraged," she added. "Most of the sessions at very large meetings are lectures. There may be an opportunity to ask questions, but not an opportunity for real dialogue or exchange. We really want to create openness."

This will be the first ICVH since 2014. Organizers planned to hold the meeting in September 2015, but postponed it until this month. At the time, José Zuniga, MD, president of IAPAC, told Medscape Medical News that the postponement resulted from a delay in securing sponsorship.

But spring is a good time for the meeting, Dr Terrault pointed out, because it is not as close to related international meetings. And the delay allowed organizers to add some great speakers. "I think we've got something for everyone. We're bringing a really comprehensive look at viral hepatitis to the attendees," she said.

Dr Terrault reports receiving grant support from Gilead, Novartis, and AbbVie; and serving as a consultant for BMS and Janssen. Dr Reau reports relationships with AbbVie, Gilead, Merck, Bristol-Myers Squibb, Boehringer Ingelheim, and Janssen.

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