Interferon-free therapy has only been used for a few years and only recently outside clinical studies. However, it has very rapidly given outstanding practical results. The hepatologists at the Medical University of Vienna had an active and leading role in the clinical development of these therapies, which also cause fewer side effects than interferon therapy.
Michael Trauner is Head of the Department of Clinical Gastroenterology and Hepatology at the Medical University of Vienna and is currently President of the Austrian Society for Gastroenterology and Hepatology [ÖGGH] and was therefore responsible for the organization of the annual meeting of the ÖGGH. He explained that real life data on the new therapies for hepatitis C in the special hepatitis outpatient clinic at the Medical University of Vienna / Vienna General Hospital were developed in national cooperation with several centres in Austria under the management of the Medical University of Vienna. These data were recently presented at the annual meetings of the European Association for the Study of the Liver [EASL]and the ÖGGH. According to Michael Trauner, the ÖGGH meeting had been most successful. There had never been so many visitors and the lectures were of the highest quality and included the newest developments in the therapy of viral hepatitis. It was clearer than ever that the annual meeting of the ÖGGH is an important annual event in Austrian gastroenterology.
According to Hofer: “On the basis of the data and developments, the scientists of the Medical University of Vienna and the ÖGGH — particularly Peter Ferenci, a scientist from the Medical University of Vienna — have demanded that patients in the early stages of hepatitis C should be treated with these new therapies in the early stages of the diseases. It is particularly encouraging that this has now been approved. This means that, from August, patients with early stage hepatitis C will be given these new therapies.
Interferon therapy for hepatitis C now practically outdated
Until now, the relatively expensive interferon-free therapy could mainly be used only in patients with advanced liver disease — for example, after liver transplantation or liver cirrhosis. Hofer explained: “The new reimbursement rules permit this therapy to be used in early stage patients too. This means that most patients will be given a highly active and simple therapy with few side effects. This is a great improvement in patient care.”
Interferon therapy had been the international gold standard for therapy of viral hepatitis for the last 25 years but had numerous undesired side effects. It is now practically outdated.
Disease without clear symptoms
About 30,000 Austrians are known to suffer from hepatitis C, but many more cases are unreported, as the disease does not have any clear symptoms. According to Hofer: “The most frequent symptom is exhaustion and this is unfortunately non-specific”. Hepatitis C is inflammation of the liver from the hepatitis C virus. It is mostly diagnosed from abnormal laboratory values. The infection may (but must not) be accompanied by jaundice. Several hundred patients are treated each year in the Department of Gastroenterology and Hepatology in the University Clinical for Internal Medicine III in the Medical University of Vienna.
Hepatitis C is transmitted by blood, perhaps during tattooing, injecting drugs by syringe, contaminated blood transfusions etc. Infection may have been years or decades previously Everyday transmission is practically impossible. The expert from the Medical University of Vienna advised members of groups at risk should have themselves tested.
Five research clusters at the Medical University of Vienna
There are in all five research clusters established at the Medical University of Vienna. These focus on areas in basic and clinical research. The research clusters include medical imaging, cancer research / oncology, cardiovascular medicine, medical neurosciences and immunology. Hepatitis research at the Medical University of Vienna is part of the immunology cluster.
1. Ferenci P, Kozbial K, Mandorfer M, Hofer H. HCV targeting of patients with cirrhosis.
J Hepatol. 2015. pii: S0168-8278(15)00393-1. doi: 10.1016/j.jhep.2015.06.003.
2. Beinhardt S, Peck-Radosavljevic M, Hofer H, Ferenci P. Interferon-free antiviral treatment of chronic hepatitis C in the transplant setting. Transpl Int. 2015. doi: 10.1111/tri.12577.
3. Sarrazin C, Berg T, Buggisch P, Dollinger MM, Hinrichsen H, Hofer H, Hüppe D, Manns MP, Mauss S, Petersen J, Simon KG, van Thiel I, Wedemeyer H, Zeuzem S. Aktuelle Empfehlungen zur Therapie der chronischen Hepatitis C [S3 guideline hepatitis C addendum]. Z Gastroenterol. 2015 Apr;53(4):320-34. doi: 10.1055/s-0034-1399322.
4. Rutter K, Stättermayer AF, Beinhardt S, Scherzer TM, Steindl-Munda P, Trauner M, Ferenci P, Hofer H. Successful anti-viral treatment improves survival of patients with advanced liver disease due to chronic hepatitis C. Aliment Pharmacol Ther. 2015;41(6):521-31.
5. Mandorfer M, Kozbial K, Freissmuth C, Schwabl P, Stättermayer AF, Reiberger T, Beinhardt S, Schwarzer R, Trauner M, Ferlitsch A, Hofer H, Peck-Radosavljevic M, Ferenci P. Interferon-free regimens for chronic hepatitis C overcome the effects of portal hypertension on virologic responses. Aliment Pharmacol Ther. 2015, in press