HCV-Genotype 5 Or 6
2015 - 2013 Genotypes and Treatment
Treating HCV genotypes 1-6
Links to treatment options for all HCV genotypes is provided, using clinical research found published online in peer-reviewed journals and presented at conferences, as well as interactive learning activities.
Feb 5 2013
Epidemiology and treatment of hepatitis C genotypes 5 and 6.
Research Article: HCV genotype 1 and 6 had significantly higher viral loads than genotype 2 and 3
July 28 2012- Hepatitis C Therapy in Non-genotype 1 Patients: The Near Future
Response-guided therapy for patients with hepatitis C virus genotype 6 infection: a pilot study.
J Viral Hepat. 2012; 19(6):423-30 (ISSN: 1365-2893)
Tangkijvanich P; Komolmit P; Mahachai V; Poovorawan K; Akkarathamrongsin S; Poovorawan YDepartment of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Department of Pediatrics, Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Summary. The optimal duration of treatment with pegylated interferon (PEG-IFN) plus ribavirin (RBV) in patients with hepatitis C virus (HCV) genotype 6 is unknown. This study was aimed at determining treatment response on the
basis of rapid virological response (RVR) of HCV genotype 6 in comparison with genotypes 1 and 3. Sixty-six treatment naïve patients were treated with PEG-IFN-α2a (180 μg/week) plus weight-based RBV (1000-1200 mg/day). Patients
with genotype 1 n = 16) and genotype 3 (n = 16) were treated for a fixed duration of 48 and 24 weeks, respectively. Patients with genotype 6 (n = 34) who achieved RVR were treated for 24 weeks (response-guided therapy) and the
remaining patients were treated for 48 weeks (standard therapy). The mean baseline HCV RNA levels were not statistically different between groups (6.4 ± 0.8, 6.0 ± 1.0 and 6.5 ± 0.8 Log(10) IU/mL for genotypes 1, 3 and 6,
respectively). Patients with genotypes 1, 3 and 6 achieved RVR in 43.8%, 87.5% and 73.5% of cases, respectively. One patient with genotype 1 and 3 with genotype 6 were considered nonresponders and discontinued therapy. Sustained
virological response (SVR) was achieved in 62.5%, 81.3% and 76.5% of patients with genotypes 1, 3 and 6, respectively. The SVR rate in patients with genotype 6 who underwent response-guided therapy was 88%. This pilot study suggested that
the SVR rate of HCV genotype 6 was at an intermediate level between those of genotypes 3 and 1. Treatment with PEG-IFN plus RBV for 24 weeks may be sufficient for patients with genotype 6 who achieve RVR. Prospective randomized
trials are required to evaluate this response-guided strategy in a larger number of patients with genotype 6.
Z Gastroenterol. 2012 May;50(5):441-444. Epub 2012
Treatment Results of Chronic Hepatitis C Genotype 5 and 6 Infections in Germany.
Mauss S, Berger F, Vogel M, Pfeiffer-Vornkahl H, Alshuth U, Rockstroh JK, Niederau C, Hüppe D.
Center for HIV and Hepatogastroenterology, Düsseldorf, Germany.
Abstract Chronic hepatitis C due to HCV genotype 5 and 6 infection is infrequently reported and patients are usually not included in trials. As boceprevir and telaprevir are not approved for these genotypes, pegylated interferon plus ribavirin will
remain the treatment of choice for the coming years. Patients infected with HCV genotype 5 or 6 were identified by data base search from an ongoing observational cohort study in Germany. Of the total 23 893 patients, 39 patients (0.2 %) carried a HCV genotype 5 and 39 patients a HCV genotype 6 (0.2 %). Compared to other genotypes patients with genotype 5 were older and more often had a history of blood transfusion. Patients with genotype 6 were more often Asian and showed higher baseline alanine transaminase. Therapy with pegylated interferon alfa-2a and ribavirin was initiated in 24 patients with HCV
genotype 5 and 27 patients with HCV genotype 6. After completion of 48 weeks of therapy an end of treatment response was achieved in 79 % and 81 % of treated patients, respectively. Sustained virological response was achieved in 58 % of patients
with genotype 5 and in 59 % genotype 6 patients. HCV genotype 5 and 6 infections are rare in Germany. Our findings suggest that most HCV genotype 6 infections are seen in migrants from Asia, whereas HCV genotype 5 infections seem more due to spontaneous local infections. Sustained virological response seems to be better than for patients with genotype 1 or 4
with similar treatment duration.
© Georg Thieme Verlag KG Stuttgart · New York.
Antiviral activity of TMC435 monotherapy in patients infected with HCV genotypes 2 to 6: TMC435-C202, a phase IIa, open-label study
Interferon and Ribavirin Control HCV Genotype 6
From Reuters Health Information
By David Douglas
NEW YORK (Reuters Health) Feb 08 - Pegylated interferon and ribavirin are effective against chronic infection with hepatitis
C virus (HCV) genotype 6, a recent study shows.
"This large randomized study provides new information on treatment of genotype 6 patients, particularly on shortening
duration of therapy in select patients (and) thus limiting costs of an expensive treatment," said Dr. K. Rajender Reddy of the University of Pennsylvania, Philadelphia in an email to Reuters Health.
Genotype 6 (which now includes genotypes 7, 8 and 9) is endemic in Southeast Asia, where it accounts for up to 47% of HCV infections. Once problematic mainly in that part of the world, "in the changing era of increasing migration of populations, it has been recently reported in the United States, as well as in China, Taiwan, and Hong Kong," Dr. Reddy and
colleagues wrote in a paper online January 17 in the Journal of Hepatology.
The interferon/ribavirin combination is the standard treatment for HCV, but genotype is considered to be a strong predictor
of sustained virological response (SVR) and little is known about response and optimal treatment duration with genotype 6, the investigators say.
The new trial included 105 treatment-naive HCV genotype 6 patients in Vietnam who were randomized to 24 or 48 weeks of
treatment with pegylated interferon alfa-2a 180 mcg per week and ribavirin 15 mg/kg per day.
The study was not funded, and the patients had to pay for their care. Six dropped out for economic reasons and another seven were lost to follow-up.
Even so, on intention-to-treat analysis the SVR was 60% in the 24-week group and 71% in the 48-week group. The difference was not significant. Corresponding biochemical responses were 63% and 77%.
Rates of virological relapse were 7% with the shorter course of treatment and 5% with the longer course.
Overall, SVR was most likely in those with a rapid virological response. In the 24-week group, 75% of such patients achieved
SVR. In the 48-week group, the proportion was 86%.
Rates of hematologic and general adverse events were similar between the two groups, except the rate of anemia was lower
with shorter treatment (31% vs 57%).
According to the paper, "24 weeks of therapy in younger patients, with low viral load and rapid virological response
appeared equally effective as 48 weeks of therapy and this is likely to have a major economic impact on HCV therapy, in such subpopulations."
In fact, Dr. Reddy noted that the efficacy of shorter-duration therapy is scientifically worth pursuing in larger trials, but
given the lack of support for the current study, "challenges are in funding."
"While new drugs are being developed for non-genotype 6 hepatitis C infections," he concluded, "pegylated interferon and
ribavirin will remain the standard of care for the foreseeable future for genotype 6 infections."
J Hepatol 2012.
HCV genotype 6 respond better to interferon-based therapy vs genotype 1
Epidemiology and Management of HCV Genotype 6
Prevalence of hepatitis C virus (HCV) genotype 6 may be as high as 50% in parts of Southeast Asia, according to a systematic review published in the August 2011 issue of Alimentary Pharmacology and Therapeutics.
Compared with genotypes 1 and 4, genotype 6 responds better to interferon-based therapy.
From Journal of Viral Hepatitis
Twenty-four Weeks of Pegylated Interferon Plus Ribavirin Effectively Treat Patients With HCV
Y. Q. Zhou; X. H. Wang; G. H. Hong; Y. Zhu;
X. Q. Zhang; Y. J. Hu; Q. Mao
Posted: 09/05/2011; J
Viral Hepat. 2011;18(8):595-600. © 2011 Blackwell Publishing
Pegylated interferon (PEG-IFN) plus ribavirin is currently the standard treatment for patients with chronic hepatitis C virus
(HCV) infection, and the optimal duration of treatment and expected response rate depend on the genotype of the infecting virus. HCV genotypes have been shown to have unique patterns of geographical distribution. HCV genotypes 1–3 are the predominant genotypes in Western Europe and the United States, and these genotypes have been the focus of most clinical trials to date. Forty-eight weeks of therapy are advised for patients with HCV genotype 1 (HCV-1) and 24 weeks for those with
HCV-2/3.[1,2] However, there is a general paucity of data on the treatment response in patients infected with other genotypes, including genotype 6.[3–5]
Hepatitis C virus genotype 6 (HCV-6) was traditionally believed to be confined to South-east Asia and was considered
anecdotal elsewhere.[3,6] However, recent studies demonstrated that the pockets of HCV-6 infections can be found worldwide.[7–12] The optimal duration of treatment and expected response rate for patients with HCV-6 infection have not yet been determined.[7,12–15] The few available results suggest that response to antiviral therapy in patients infected with HCV-6 is superior to that in patients infected with HCV-1 and may be similar to that in patients infected with HCV-2/3.[7,12–15] Until now, there has been only one study that compared the treatment outcome of HCV-6 with that of HCV-2/3 directly.
Moreover, previous reports have shown that the on-treatment virological response appears crucial for both tailoring the duration of therapy and influencing the treatment outcome,[16,17] although no data are available concerning the association of the on-treatment virological response with the sustained virological response (SVR) in patients infected with HCV-6.
The frequencies of HCV-6a and HCV-3 have significantly increased in south-west China, and the traditional HCV-1b and HCV-2a are also present. In recent years, patients with HCV-6a infection have been diagnosed and treated with PEG-IFN and ribavirin in the Southwest Hospital, in south-west China. The aims of this study were to determine the treatment outcome in patients with HCV-6a infection in comparison with HCV-2/3 as well as HCV-1b and assess the association of the on-treatment virological response with the SVR.