Pre-exposure prophylaxis (PrEP), a method in which antiviral drugs are given to people before they are infected with an illness, already works to help prevent HIV infection. Now, some hepatitis C virus (HCV) researchers want to apply that same medical concept to help stop liver disease in its tracks, according to a recent editorial published in Hepatology.
The report, written by Gregory Dore, PhD, of The Kirby Institute at the University of New South Wales in Australia, argues that ongoing high-risk behavior—such as unsafe sex among HIV-positive men who have sex with men (MSM) and injection drug use—makes certain people so likely to get hepatitis C in their lives and so likely to be reinfected with the illness, that it’s better to try to prevent an infection instead.
The article goes on to use mathematical modeling to create a “pessimistic scenario” in which up to 20 percent of HIV-positive men who have sex with men (MSM) engage in high-risk sexual behaviors. If this were to happen, Dore argues, treating all new cases of hep C every year among this at-risk group still would not help stop the spread of the virus.
But according to Dore, giving hepatitis C medications to at-risk people before they are infected could help prevent the liver virus from taking hold in their bodies. His approach would follow the science behind HIV PrEP to see whether the method could be used for other blood-borne illnesses.
Drug pricing is apparently not an issue to the author, because the Australian government currently subsidizes the cost of antiviral treatment for hepatitis C without restrictions. In fact, in the editorial, Dore argues that Australia could be the “ideal setting” for testing HCV treatment as prevention (TasP).
It’s also important to note that Dore is a research consultant who has received grants from Abbvie, Bristol-Myers Squibb, Gilead, Merck and Janssen. Whether or not the approach will gain any footing in the larger HCV research community has yet to be determined. However, in the modern age of treatment as prevention, it’s an interesting idea to consider.