Why is hepatitis C treatment less effective for some strains of the virus that are more common in developing countries?

🧪 What was the study about?

Hepatitis C is treatable with direct-acting antivirals (DAAs), with cure rates of over 90%. However, some strains of hepatitis C virus may not respond as well to DAAs. These strains (sometimes called ‘endemic’ strains) are more common in developing countries and in migrants from these countries. We want to look at the genetic material of these virus strains to understand why the treatment doesn’t always work.

❓ Why is this important?

It is important to understand why some treatments might not work as well in people with certain strains of the hepatitis C virus, so that treatment guidelines can be improved for these groups and more people can be successfully cured. This will reduce the spread of hepatitis C and support targets set by the World Health Organisation to control and reduce the number of hepatitis C infections and deaths from hepatitis C.  

🔍 What did we do?

We looked at data collected through the English national hepatitis C treatment program. We included people where we knew what strain of hepatitis C virus they were carrying and whether DAA treatment was successful or not. We looked at the genetic material of the virus to find out why some treatments do not work.

📊 Key findings

We confirmed that people with ‘endemic’ strains of hepatitis C were less likely to be cured by some DAAs than people with other strains. We also found combinations of DAAs that worked better at treating those with ‘endemic’ strains and identified genetic features of the virus which make it harder for treatment to work.

💡 What do these findings mean?

These findings will be used to update treatment guidelines for people living with hepatitis C and the planning and organisation of healthcare resources.