The PURGE-C trial (A5380) tested whether a shortened four-week course of glecaprevir/ pibrentasvir (G/P) could cure people with early hepatitis C virus (HCV) infection. Among 45 participants in the U.S. and Brazil—half of whom were also living with HIV—84% were cured. The regimen was safe, well tolerated, and those who were not cured by the short course were successfully cured with standard retreatment, with no evidence of resistance. While cure rates were slightly lower than with the longer 8–12 week regimens that are currently the standard of care, this study shows that abbreviated therapy can be effective, particularly for individuals who are at high risk for transmitting HCV who may face barriers to completing a longer course of treatment. Thus, short-course treatment could be an important tool to support HCV elimination efforts.
Why it matters:
The World Health Organization has set a goal of eliminating hepatitis C as a public health threat by 2030. Yet, in the U.S., thousands of new infections occur each year—often among people who face barriers to staying in care. Shorter, simpler treatment courses could help close this gap and reduce onward transmission.
Arthur Y Kim, Minhee Kang, Triin Umbleja, Estevão P Nunes, Kristen M Marks, Anne F Luetkemeyer, Carrington Koebele, Chanelle Wimbish, Daniel S Fierer, Dimas A Kliemann, Sunil S Solomon, Jens Kort, Jennifer J Kiser, Georg M Lauer, Raymond T Chung, Leonard A Sowah, Beverly L Alston-Smith, David L Wyles, Susanna Naggie, for the A5380 Study Team; Clinical Infectious Diseases, ciaf305, https://doi.org/10.1093/cid/ciaf305