Study proves hepatitis C drugs reduce liver-related deaths by nearly half

DALLAS –
Aug. 10^th, 2019 – A new study from the UT Southwestern Simmons
Comprehensive Cancer Center demonstrates that antiviral drugs for hepatitis C
reduce liver-related deaths by nearly 50% in patients with a history of liver
cancer.

The finding
builds on a December 2018 study by the same researchers who found that
antiviral drugs do not increase the risk of liver cancer recurrence, as was
previously feared.

Dr. Amit
Singal’s study was published in the journal Gastroenterology on July 30. Dr.
Singal is an Associate Professor of Internal Medicine, Medical Director of the
UT Southwestern Liver Tumor Program, and Clinical Chief of Hepatology. He
collaborated on these studies with Dr. Caitlin Murphy, Assistant Professor of
Population and Data Sciences and Internal Medicine. They are both members of
the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern.

Their
studies overturn prior misconceptions that made doctors reluctant to prescribe
direct-acting antivirals to treat hepatitis C in patients with a history of
liver cancer. Many doctors previously believed that hepatitis C, for all its
harmfulness, activates the immune system when it infects the liver, and the
immune system kept liver cancer recurrence at bay.

But this
notion appears to be false. Drs. Singal and Murphy studied nearly 800 patients
from 31 medical centers across the country and found that the drugs are not
only safe, they decrease death from cirrhosis and liver cancer by 46%.

“Not only
are these drugs safe in this patient population, but we have now demonstrated
that they are helpful,” Dr. Singal said. “Our study changes the paradigm from
you could treat a patient’s hepatitis C to you should treat it.”

Dr. Carlos
L. Arteaga, Director of the Simmons Cancer Center, said the study’s scope and
impact are something that can only be produced by a National Cancer
Institute-designated Comprehensive Cancer Center.

“Dr. Singal
had more patients involved in the study than any other participating site. As
an epidemiologist, Dr. Murphy brought rigor to the data that removes prior
doubt on this issue,” he said.

Dr. Murphy
said previous studies compounded the misunderstandings of direct-acting
antiviral therapy because they, among other things, failed to account for the
timing of therapy relative to liver cancer diagnosis, did not include a
comparison group, or did not properly consider clinical differences among
patients.

The new
study is a significant contribution because it clears the path to beneficial
drug treatment.

“Hepatitis
C therapy is so important because it provides a cure,” Dr. Singal said.
“You take oral medications for two or three months, with minimal to no side
effects, and you’re done. You’re cured of hepatitis C. There’s less than a 1%
chance of relapse if you’re cured of hepatitis C.”

Defeating
hepatitis C is an important step because infection can otherwise lead to
cirrhosis – scarring of the liver – which can be deadly. Cirrhosis can increase
the risk for liver cancer, which also may be fatal. Curing hepatitis C with
antivirals breaks the first link in a deadly chain of events and can lead to
improvement in liver function among those who have previously developed
cirrhosis.

Hepatitis C
rapidly made its way into the American blood stream in the 1970s and 1980s when
intravenous drug use spiked and blood products were not screened for the
hepatitis C virus. Hepatitis C infected 2 to 3% of the baby boomer population,
the largest generation in U.S. history. Millions were affected.

The disease
can lie dormant for 25 to 30 years and resurface as a life-threatening specter
years after someone has stopped using drugs and turned to a healthy lifestyle.
Hepatologists saw an alarming spike in cirrhosis as baby boomers aged. By 2017,
The New York Times called hepatitis C “an enormous public health problem.” In
2018, the Centers for Disease Control and Prevention announced there were
nearly 2.4 million people living with hepatitis C in the U.S.

“Dr.
Singal’s and Dr. Murphy’s study reports a welcome, fact-based way to oppose the
adverse effects of hepatitis C infection in various demographic groups,” Dr.
Arteaga said. “Their findings will have a global, lifesaving impact on how
hepatitis C is treated. It is particularly important to Texas because the liver
cancer incidence rate in Texas is the highest in the nation.”

Dr. Arteaga
said the study is also important because liver cancer is highest among the
Hispanic population in Texas, and research-based advances in reducing cancer in
underserved groups are a Simmons Cancer Center priority.

The Simmons
Cancer Center stands among only 32 U.S. cancer research centers named by the
National Cancer Institute as a National Clinical Trials Network Lead Academic
Participating Site.

The authors
declared financial interests with the manuscript.

UT Southwestern, one of the premier academic medical centers in the US, integrates pioneering biomedical research with exceptional clinical care and education.

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