Published: Nov 4, 2013
By Michael Smith, North American Correspondent, MedPage Today
Culture Shock is a blog by Michael Smith for readers with an interest in infectious diseases.
WASHINGTON -- A few years back, a prominent liver researcher was asked if he was delaying hepatitis C treatment for patients not in urgent need. After all, new, less toxic, more effective treatments would soon be on stream. Why push patients into current regimens, often hard to take and always very toxic?
"Yes," the doc replied, deadpan. "In fact, I've had to add a new floor to my warehouse."
He and others may be running up whole new buildings if some preliminary research, presented here at the annual meeting of the American Association for the Study of Liver Diseases, comes to fruition.
Think of this -- a single infusion that cures HCV.
We're getting perilously close to magic bullet territory here. One doctor I spoke to here said she'd postpone therapy for most of her patients -- even with the newer, gentler drugs -- if there was a possibility that a single shot could cure the disease.
In a plenary presentation, David Suhy, PhD, of Tacere Therapeutics of San Francisco, outlined the idea: A recombinant virus vector that gives rise to hairpin RNA segments that target three parts of the HIV genome. Once integrated into liver cells, the RNAs interfere with HCV replication as long as the cells live.
Upside? It's a single infusion so there would be no compliance or adherence issues. And the treatment is over, just like that.
The downside is that there's no way to stop or reverse the therapy once it's administered.
The pre-clinical data look good and the stuff is intended to go into early human trials next year, Suhy said.
It's important to emphasize that this is not ready for prime time, not by a long shot. We all know of very promising drugs that have fallen to the ground during clincial trials.
But if it looks as if it's working, it could put all of the new HCV drugs off the shelf, even before they've had much of a chance to get on.