A new long-term follow-up study of chronic hepatitis C patients has shown early treatment and disease eradication is associated with lower rates of liver fibrosis progression.

It comes just months after the release of a controversial and widely criticised Cochrane Review report questioning the efficacy of new hepatitis C drugs in saving lives.

The Review authors were roundly condemned for their report, which concluded they could neither confirm nor reject that direct-acting antivirals (DAAs) had any clinical effects.  After analysing 138 trials with a total of 25,232 participants, the authors said the research on hepatitis C medications had a high risk of bias.

In response to the report, a joint Position Statement was prepared by an expert panel representing the Gastroenterological Society of Australia (Australian Liver Association), the Australasian Society for Infectious Diseases, the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, the Australasian Hepatology Association, Hepatitis Australia and the Royal Australian College of General Practitioners.

“The organisations above developed this position statement to urge health practitioners and patients not to be swayed by this flawed report claiming new direct-acting antivirals (DAAs) for hepatitis C do not save lives,” the panel said in a statement.

The position statement went on to affirm the clinical benefits of DAAs, which offer sustained virological response (SVR).

“SVR is a marker for cure of hepatitis C,” the statement said. “Clearing the hepatitis C virus has been shown in natural history and prior treatment studies to substantially reduce the risk of liver cancer and liver failure, reducing mortality from cirrhosis and liver cancer. Curing hepatitis C can also improve quality of life, including physical, emotional, and social health; decrease concerns regarding transmission, and alleviate suffering associated with such a stigmatized illness.”

GESA-ALA chair Professor Alex Thompson was vocal in his condemnation of the Cochrane Review, expressing concern that it could deter patients from seeking treatment.

However he told the limbic this week that the huge reaction from the medical community both in Australia and overseas had minimised the damage.

“The strength of the backlash has prevented too much negative publicity,” he said.

And in the meantime, the new study found sustained virological response halted fibrosis progression in people with chronic hepatitis C infection.

Professor Thompson, a co-author of the study, said the results showed categorically that curing hepatitis C prevented the progression of liver disease.

“The HCV eradication is associated with lower rates of liver fibrosis progression. The data support early treatment to prevent long-term liver complications of HCV infection,” the authors concluded.

Professor Thompson said the results were vindicating after the negativity of the Cochrane report.

“There is a definite clinical benefit from curing hep C,” he said.

He said he stood by his view that the Cochrane report was ‘flawed’ and even ‘inflammatory’ in its conclusions, and the timing of this latest study couldn’t have been better.

“It was coincidental, but well-timed,” he said. “I think it will reassure clinicians, but even more the affected community that treatment is a good thing.”

Meanwhile, he said it was full steam ahead for programs aimed at improving access to hepatitis C treatment. The program is being rolled out at community health centres, opiate replacement clinics and general practice. Some 1,000 inmates at a Victorian correctional centre are also taking part in a treatment program.

While Professor Thompson believes complete eradication of hep C in Australia may be overambitious, an eradication rate of 90 per cent was achievable.

“Treatment of hepatitis C is definitely moving out of hospitals,” he said. “It’s hoped that in time, GPs will become the dominant prescribers for hepatitis C treatment.”

“We have great access to hep C medications and treatment, and it’s possible that in the next 10 years we can eliminate hep C as a public health risk,” he said.