Acute hepatitis C: treat early, and eight weeks of DAAs cures almost everyone

The edition in brief

A meta-analysis of 14 studies (1,078 patients) treating acute or recently acquired hepatitis C with two direct-acting antivirals found a pooled SVR12 of 97.7%, rising with duration: 85% at four weeks, 92% at six, 99% at eight and 97% at twelve. A prospective study at 63 centres found one-year mortality after liver transplantation was 9% without ACLF, about 10% with ACLF-1 or -2 and 21% with ACLF-3, rising to 42% with five or six organ failures; 73% of declined ACLF-2 and 88% of declined ACLF-3 patients died within a year. A phase 2 single-arm study of eight weeks of bemnifosbuvir and ruzasvir in 275 treatment-naive patients with chronic HCV reported SVR12 of 90% overall and 98% in adherent patients. Six cohorts of 173 children with IBD switched from intravenous to subcutaneous infliximab maintained remission in 93% with rare new antibodies, though the subcutaneous form is not licensed under 18.