In recent days there has been media coverage of a new study that casts doubt upon the effectiveness of new hepatitis C treatments. Given the potential that the coverage of this study has to mislead patients, The Hepatitis C Trust wishes to make clear that we have fundamental doubts as to the credibility of the research. Along with leading clinicians and scientists, we have written to The Guardian to express our concern. The letter states:
We are clinicians and scientists who have studied and treated patients with chronic hepatitis C virus infection over many years and patient groups who represent those affected by hepatitis C.
We write in response to your damaging article on the effectiveness of antiviral therapy. The Cochrane review that you highlight analysed clinical trials, which are by nature short term, where the sole purpose was to evaluate the virological efficacy of new antiviral drugs. The trials were neither designed, nor powered, to assess mortality, so it is not at all surprising that the Cochrane review was unable to identify any impact on mortality.
Regulatory authorities and clinicians all recognise that clearing hepatitis C virus reduces mortality. Indeed, UK-based research demonstrates that oral antiviral treatment for patients with hepatitis C who also have cirrhosis substantially decreases mortality and morbidity (Cheung et al Journal of Hepatology 2016).
Current data from Public Health England reveal that there has already been an 11% reduction in mortality following the introduction of antiviral therapy as well as a 50% reduction in a need for liver transplantation for chronic hepatitis C infection, with the added benefit that more donor organs will now be available for patients without viral hepatitis.
These data are supported by similar analyses worldwide. The Cochrane analysis is fundamentally flawed, does not reflect international experience of the benefits of antiviral therapy and has the potential to deter patients with hepatitis C from seeking life-saving antiviral therapy.
The real story is one of remarkable, if surprising, success over just a decade, transforming an unpleasant and sometimes fatal disease into one that is readily cured.
Graham R Foster, Professor of Hepatology, Queen Mary University of London
William Irving, Professor of Virology, University of Nottingham
John McLauchlan, Professor of Viral Hepatitis, University of Glasgow,
Charles Gore, CEO, The Hepatitis C Trust and President, World Hepatitis Alliance
Graeme JA Alexander, President, British Association for the Study of The Liver
* Published by the The Guardian on June 13 2017