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Gilead’s Triple-Drug Hepatitis C Regimen Works Well for Cirrhotic Genotype 3s

What is a Hepatitis C Genotype?

In the process of testing positive for hepatitis C infection, a patient is given three tests. The first checks whether there was ever exposure to the virus. If the test result is negative, there is no way the person could currently be infected with the virus, so the testing stops. If the test result is positive, the second test checks whether the body has the viral infection. This is because not everyone who is exposed to a virus becomes ill and because approximately 25% of people who become infected with hepatitis C are able to internally battle the virus and beat it without medical intervention. If that test comes back positive, the patient does have the virus. However, there are numerous versions or genotypes of the virus, which is the final test. Knowing which genotype the patient has helps to inform the doctor about which medication may be the best fit for them.

Why Do Different Genotypes Need Different Drugs?

A genotype is the specific genetic makeup of something; in this case, it is the specific genetics within the hepatitis C virus that a patient has. In its simplest example, some people can think of genotypes as children’s blocks that come in different shapes. They are all categorized as wooden blocks (just as the genotypes are all categorized as hepatitis C), however, there is a difference between a square block and a circle block. The medication for hepatitis C can be thought of like the children’s game of placing the right block through the right hole. If you know you have one hole, you can test different blocks until you find one that fits, but it is far quicker and easier to know the shape of the hole so you can choose the right block. Testing for genotype is similar; knowing which genotype the patient has allows the doctor to choose the best medication for that patient’s needs.

Some genotypes offer more than one medication option. This is because some of the medications may be outdated, because some medications may have different side effects, and because different medications can cost wildly different prices. For example, at the beginning of hepatitis C treatment, there was one drug (interferon) that was given to all patients, regardless of genotypes. It was the only option. However, it had many uncomfortable side effects. As medical interventions continued to advance, drug manufacturers began to work to create new medications with fewer side effects, as well as medications that were intended to focus on specific genotype-based needs.

What is Different about Gilead’s Triple-Drug Hepatitis C Regimen?

This drug treatment is a combination drug using three drugs that have already been in use for a number of years: sofosbuvir, velpatasvir, voxilaprevir. While some patients begin with one medication and need to switch to another, it is rare that so many drugs be combined into one treatment plan. This is a new method of treatment. In the drug trials, which included approximately 200 test subjects, 96% of previously untreated subjects and 99% of previously treated subjects were considered to be cured after using this new combination drug for 8 weeks. In addition, the most common side effects were diarrhea and nausea. Testing has also shown that 6 weeks of the medication may be as effective. This is a significant reduction in time from the more standard 12 week course of treatment. Shorter timeframes may lead to an increased consistency in patient compliance and to lower overall costs of treatment.

What Happens Next?

As there were no known severe medical complications from the drug, the drug will continue to be tested on human subjects. If the drug continues to show positive responses in the patients being tested, the testing group will be expanded and new trials will occur. The drug trial process is lengthy as the government does not ever wish to expose the general public to medication that may have severe or unknown results. If the drug completes all of its testing without cause for concern, Gilead will submit their research to the American Federal Drug Administration (FDA), the United States’ governing body for drug approval. There, the drug information will be reviewed and, if it is considered safe enough to be beneficial to the public, it will earn FDA approval. At that time, Gilead will own the exclusive right to market this drug for a number of years. It will begin to market the drug to physicians and it will begin to mass produce the drug so it can be sent to pharmacies nationwide. Insurance companies will begin to consider whether to include the new drug in their coverage plans. As they do this, they will consider whether previously existing medications work as well nearly as well or whether there is a significant enough difference to be worth the expense of covering a new medication. This means that it may be several months or even years before this drug is available to the public, depending on the test results and the FDA. That said, this may become the next drug to treat patients with hepatitis C and its use of three drugs in its combination may become the wave of the future for hepatitis C medications.1-4

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Gilead’s Triple-Drug Hep C Regimen Works Well for Cirrhotic Genotype 3s. (2016). Hep. Retrieved 26 February 2017, from
  2. Highleyman, L. (2015). Gilead triple combination cures easy-to-treat hepatitis C patients in 6 weeks, but 4 weeks is not enough. Retrieved 26 February 2017, from
  3. Le, T. & Wogen, J. (2003). Evaluation of hepatitis C genotype testing in newly diagnosed hepatitis C managed care patients. Hepatology, 38, 749-749.
  4. Nahass, R. (2016). Sofosbuvir/Velpatasvir Plus GS-9857(100MG) for 6, 8, or 12 Weeks in Genotype 1-6 HCV-Infected Patients: An Integrated Analysis of Safety and Efficacy from Two Phase 2 Studies. Retrieved 26 February 2017, from