Before we can get into the definition of pan-genotypic, let’s back up and talk about genotypes overall. Currently, there are seven known hepatitis C genotypes (called “genotype 1,” “genotype 2,” and so on). However, some field experts think there might be even more genotypes – at least eleven.
Different genotypes impact the genetic makeup of hepatitis C (hep C) in different ways, with up to 1/3 of a difference in each genotype. This means that the viruses are different if one is within genotype 1 and another is within genotype 2. That means that the medications that work for genotype 1 might not work at all or might be less effective in someone with genotype 2. As a result, when it comes to treating people who have hep C as effectively as possible, the genotype matters. The most common genotype is genotype 1. Genotypes 2 and 3 are fairly common, and the other known genotypes (4, 5, 6, 7) are incredibly rare (less than 1% of people combined have these genotypes).
Based on this information, most medications are targeted toward the genotypes 1, 2, and 3. This makes sense, as this accounts for approximately 99% of all hepatitis C infections. However, what works great for one might not work for another, which means that, in the past, there has been some trial and error when it comes to hep C medication. It also means that some do not have medication-based relief of symptoms during the period of time in which their physician is narrowing down what medication is best, based on which genotype of hepatitis C the particular patient has.
Obviously, this can be a very stressful process for everyone involved, and it can be expensive, since it may mean multiple visits to the doctor (including office fees, commuting costs, missing work, arranging childcare, etc.), as well as spending money on medications that may not work.
This is where pan-genotypic drugs come in. Pan-genotypic means that the drug treats numerous genotypes, not just one.
How does this research impact Hep C in general?
With information available that has lead to one initial drug that is pan-genotypic (currently being researched by Gilead), it is possible for researchers to begin to measure the impacts of such a drug. This is information that can be incredibly important to drug makers, since it helps them to decide whether it is worth putting more money into finding additional pan-genotypic drugs for those with hepatitis C.
Researchers will measure the frequency of doctors prescribing this new medication compared to the previously existing medications. They will measure how often patients purchase the new medication, and they will begin to ascertain whether pan-genotypic drugs can become profitable for their drug company. If one company believes there is enough profit to be made, other companies will likely take notice and begin their own research.
Thus, if the first pan-genotypic drug is successful among doctors and patients, it could be the beginning of many more pan-genotypic drug options in the future.
How can this new research benefit me and impact my experience with Hep C?
Some researchers believe that an individual with hepatitis C can have multiple genotypes in their viral load, even as much as 25%. For those people, current medications may never have worked as well as one would wish, since they could only truly be targeting one genotype at a time. With the new pan-genotypic drug (right now, being tested by Gilead), treatment options may be better.
This might mean a greater reduction in your symptoms, this might mean a drop in your viral load, or it might mean that you’ll need to take fewer medications to control your infection. In addition, the treatment method(s) being offered to you in the present or in the future may be much more effective for your specific virus’ genotype (or genotype combination) than you’ve experienced with previous treatment options.
If you have struggled with finding medication that works for you, do not give up hope, see your doctor to discuss the new possible options.
Just remember that research is ongoing, and as initial research is being done for pan-genotypic medication options, it is best to speak with your physician if you have questions about your current medication(s) or whether the new pan-genotypic option is right for you and your individual needs.
As is true with all medication, it is important not to self-diagnose or use a friend’s prescription to test whether something may work for your own infection. Only your doctor will know your own medical history, and they can help you to understand which medications and medical options are best for you.
Carroll, J. (2016). Gilead's new pangenotype hep C combo scores stellar results in PhIII. FierceBiotech. Retrieved 7 February 2016, from http://www.fiercebiotech.com/story/gileads-new-pan-genotype-hep-c-combo-scores-stellar-results-phiii/2015-09-21
Franciscus, A. (2016). Pan-Genotypic Drugs. HEP. Retrieved 7 February 2016, from https://www.hepmag.com/article/pangenotypic-drugs
Kolonko, C. (2016). Gilead Seeking FDA Approval for Pan-Genotype Hepatitis C Drug. MD Magazine. Retrieved 7 February 2016, from http://www.hcplive.com/medical-news/gilead-seeking-fda-approval-for-pan-genotype-hepatitis-c-drug
Nytimes.com,. (2015). Costly Hepatitis C Drugs for Everyone?. Retrieved 7 February 2016, from http://www.nytimes.com/2015/09/02/opinion/costly-hepatitis-c-drugs-for-everyone.html?_r=0